Search results

Minimizing the knowledge-to-action gap; identification of interventions to change nurses' behavior regarding fall prevention

Background: The need for effective continuing education is especially high in in-hospital geriatric care, as older patients have a higher risk of complications, such as falls. It is important that nurses are able to prevent them. However, it remains unknown which interventions change the behavior of nurses. Therefore, the aim of this study is to identify intervention options to change the behavior of hospital nurses regarding fall prevention among older hospitalized patients. Methods: This study used a mixed method design. The Behavior Change Wheel (BCW) was used to identify intervention functions and policy categories to change the behavior of nurses regarding fall prevention. This study followed the eight steps of the BCW and two methods of data collection were used: five focus groups and three Delphi rounds. The focus groups were held with hospital nurses (n = 26). Geriatric experts (n = 11), managers (n = 13) and educators (n = 13) were included in the Delphi rounds. All data were collected within ten tertiary teaching hospitals in the Netherlands. All participants were included based on predefined in- and exclusion criteria and availability. Results: In Geriatric experts’ opinions interventions targeting behavior change of nurses regarding fall prevention should aim at ‘after-care’, ‘estimating fall risk’ and ‘providing information’. However, in nurses’ opinions it should target; ‘providing information’, ‘fall prevention’ and ‘multifactorial fall risk assessment’. Nurses experience a diversity of limitations relating to capability, opportunity and motivation to prevent fall incidents among older patients. Based on these limitations educational experts identified three intervention functions: Incentivisation, modelling and enablement. Managers selected the following policy categories; communication/marketing, regulation and environmental/social planning. Conclusions: The results of this study show there is a discrepancy in opinions of nurses, geriatric experts, managers and educators. Further insight in the role and collaboration of managers, educators and nurses is necessary for the development of education programs strengthening change at the workplace that enable excellence in nursing practice. DOI: https://doi.org/10.1186/s12912-021-00598-z

Guidelines for digital gap self-assessment [Deliverable 2.1]

Design of a Remote Coaching Program to Bridge the Gap From Hospital Discharge to Cardiac Rehabilitation: Intervention Mapping Study

Background: Remote coaching might be suited for providing information and support to patients with coronary artery disease (CAD) in the vulnerable phase between hospital discharge and the start of cardiac rehabilitation (CR).Objective: The goal of the research was to explore and summarize information and support needs of patients with CAD and develop an early remote coaching program providing tailored information and support.Methods: We used the intervention mapping approach to develop a remote coaching program. Three steps were completed in this study: (1) identification of information and support needs in patients with CAD, using an exploratory literature study and semistructured interviews, (2) definition of program objectives, and (3) selection of theory-based methods and practical intervention strategies.Results: Our exploratory literature study (n=38) and semistructured interviews (n=17) identified that after hospital discharge, patients with CAD report a need for tailored information and support about CAD itself and the specific treatment procedures, medication and side effects, physical activity, and psychological distress. Based on the preceding steps, we defined the following program objectives: (1) patients gain knowledge on how CAD and revascularization affect their bodies and health, (2) patients gain knowledge about medication and side effects and adhere to their treatment plan, (3) patients know which daily physical activities they can and can’t do safely after hospital discharge and are physically active, and (4) patients know the psychosocial consequences of CAD and know how to discriminate between harmful and harmless body signals. Based on the preceding steps, a remote coaching program was developed with the theory of health behavior change as a theoretical framework with behavioral counseling and video modeling as practical strategies for the program.Conclusions: This study shows that after (acute) cardiac hospitalization, patients are in need of information and support about CAD and revascularization, medication and side effects, physical activity, and psychological distress. In this study, we present the design of an early remote coaching program based on the needs of patients with CAD. The development of this program constitutes a step in the process of bridging the gap from hospital discharge to start of CR.

Happiness and limits to sustainable tourism mobility: a new conceptual model

Current leisure mobility patterns are not sustainable. Because energy efficiency measures appear insufficient to accommodate predicted future volume growth, changes in transportation modes and volume are needed. Short-haul should be the preferred distance, public transportation the preferred mode and length of stay should increase rather than trip frequency. However, tourists are unwilling to adopt these changes. This paper proposes a new conceptual "three-gear model" demonstrating how happiness, travel motivations and perception of distance set barriers for desirable behavioral change. The model improves understanding of the gap between awareness of, and attitudes to, tourism mobility and the gap between environmentally friendly everyday behaviors and unsustainable vacation behaviors. The paper shows that happiness is integral to all stages of the tourist experience. Understanding happiness enhances the understanding of tourist behavior, and how it drives, via the speed-distance-demand loop, the three-stage model presented here. Key practical implications include the need for effective policies to break the speed-distance-demand loop, changes to transport infrastructure policies, and recognition of the role of happiness in sustainable tourism strategies. Theoretical contributions include a synthesis of theories to interrogate key behavioral gaps and a theoretical basis for future empirical studies.

Voluntary carbon offsets a solution for reducing tourism emissions? assessment of communication aspects and mitigation potential

Contrary to most sectors, to date the tourism and aviation industries have not managed to level off greenhouse gas emissions. Moreover, effective mitigation through technological innovation or structural and behavioural change cannot be expected shortly. Airlines and tourism companies appear to use carbon offsetting as a last resort. However, offsetting is generally acknowledged as a second-best solution for mitigating emissions, after reducing energy use. This paper seeks to determine the mitigation potential of voluntary carbon offsetting by comparing public and industry awareness of climate change and aviation emissions, and attitudes to various mitigation measures with relevant online communication by 64 offset providers. Methods were a literature review and online content analyses. Overall, the gaps that were identified between awareness, attitude and actual behaviour are not bridged by provider communication. From this perspective, the mitigation potential of voluntary carbon offsetting for achieving reductions of tourism transport emissions is estimated as low. The same conclusion is reached by comparing carbon dioxide volumes of flight offsets with actual air travel emissions. Current sales of flight offsets compensate less than 1% of all aviation emissions.

Preparation for your Foreign Learning Experience

It is a well-known fact that a good preparation in the pre-departure stage can maximize the chances of a succesful foreign experience. But what is meant by a good preparation? And what are the expected results of such a preparation? This course focuses in internship and study abroad (pre-departure) preparation. Its aim is to prepare you for the personal, professional and academic challenges of living and working abroad. The course will address awareness and purpose in the acquisition of attitude, knowledge and skills related to international competencies.