Background: Effective telemonitoring is possible through repetitive collection of electronic patient-reported outcome measures (ePROMs) in patients with chronic diseases. Low adherence to telemonitoring may have a negative impact on the effectiveness, but it is unknown which factors are associated with adherence to telemonitoring by ePROMs. The objective was to identify factors associated with adherence to telemonitoring by ePROMs in patients with chronic diseases. Methods: A systematic literature search was conducted in PubMed, Embase, PsycINFO and the Cochrane Library up to 8 June 2021. Eligibility criteria were: (1) interventional and cohort studies, (2) patients with a chronic disease, (3) repetitive ePROMs being used for telemonitoring, and (4) the study quantitatively investigating factors associated with adherence to telemonitoring by ePROMs. The Cochrane risk of bias tool and the risk of bias in nonrandomized studies of interventions were used to assess the risk of bias. An evidence synthesis was performed assigning to the results a strong, moderate, weak, inconclusive or an inconsistent level of evidence. Results: Five studies were included, one randomized controlled trial, two prospective uncontrolled studies and two retrospective cohort studies. A total of 15 factors potentially associated with adherence to telemonitoring by ePROMs were identified in the predominate studies of low quality. We found moderate-level evidence that sex is not associated with adherence. Some studies showed associations of the remaining factors with adherence, but the overall results were inconsistent or inconclusive. Conclusions: None of the 15 studied factors had conclusive evidence to be associated with adherence. Sex was, with moderate strength, not associated with adherence. The results were conflicting or indecisive, mainly due to the low number and low quality of studies. To optimize adherence to telemonitoring with ePROMs, mixed-method studies are needed.
Introduction: In 2011 5,3 million people had a chronic disease. Secondly patients want to have more influence in regulating their own disease. Self-management is increasingly being mentioned as a possible solution. However the practice learns that this involves ethical dilemmas, which nurses are often confronted with. Aim: ‘What factors are important for nurses who promote self-management in patient with a chronical disease to maintain a healthy lifestyle, while taking into account de patients’ autonomy?Method: a literature search was done in databases Pubmed and Cochrane. Inclusion criteria were: Qualitative research studies published after 2003 in English or Dutch language, concerning adult patients with a chronical disease and related to the nursing profession.Secondly a semi-structural interview was done with two dialysis care professionals and transcripted verbatim. Results: Six studies met the selection criteria and were used to answer the question. The literature data indicate five factors that influence self-management: (1) Professional attitude of nurses: nurses use their own values and convictions in ethical decisions which leads to moral conflicts (2) Shared-decision making: sharing knowledge as a professional with the patient is a significant component in giving the patient autonomy (3) Patient directed support contributes to the success of self-management (4) Change of the traditional relation as professional-patient into a professional cooperation (5) Reflection on ethical dilemmas.During the semi-structural interviews as most important aspects of self-management were mentioned that patients must be informed adequately and supported by making decisions. Patients autonomy must be central in the organization of care. Conclusion: Within self-management the patient should be in a central position. While performing self management care, nurses can be confronted with personal opinions that conflict with patients’ values. Shared decision making, patient directed support, professional attitude of the caregivers and reflection on ethical dilemmas, are key elements for effective self-management.
Alongside the growing number of older persons, the prevalence of chronic diseases is increasing, leading to higher pressure on health care services. eHealth is considered a solution for better and more efficient health care. However, not every patient is able to use eHealth, for several reasons. This study aims to provide an overview of: (1) sociodemographic factors that influence the use of eHealth; and (2) suggest directions for interventions that will improve the use of eHealth in patients with chronic disease. A structured literature review of PubMed, ScienceDirect, Association for Computing Machinery Digital Library (ACMDL), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) was conducted using four sets of keywords: “chronic disease”, “eHealth”, “factors”, and “suggested interventions”. Qualitative, quantitative, and mixed-method studies were included. Four researchers each assessed quality and extracted data. Twenty-two out of 1639 articles were included. Higher age and lower income, lower education, living alone, and living in rural areas were found to be associated with lower eHealth use. Ethnicity revealed mixed outcomes. Suggested solutions were personalized support, social support, use of different types of Internet devices to deliver eHealth, and involvement of patients in the development of eHealth interventions. It is concluded that eHealth is least used by persons who need it most. Tailored delivery of eHealth is recommended
Dutch society faces major future challenges putting populations’ health and wellbeing at risk. An ageing population, increase of chronic diseases, multimorbidity and loneliness lead to more complex healthcare demands and needs and costs are increasing rapidly. Urban areas like Amsterdam have to meet specific challenges of a growing and super divers population often with a migration background. The bachelor programs and the relating research groups of social work and occupational therapy at the Amsterdam University of Applied Sciences innovate their curricula and practice-oriented research by multidisciplinary and cross-domain approaches. Their Centres of Expertise foster interprofessional research and educational innovation on the topics of healthy ageing, participation, daily occupations, positive health, proximity, community connectedness and urban innovation in a social context. By focusing on senior citizens’ lives and by organizing care in peoples own living environment. Together with their networks, this project aims to develop an innovative health promotion program and contribute to the government missions to promote a healthy and inclusive society. Collaboration with stakeholders in practice based on their urgent needs has priority in the context of increasing responsibilities of local governments and communities. Moreover, the government has recently defined social base as being the combination of citizen initiatives, volunteer organizations , caregivers support, professional organizations and support of vulnerable groups. Kraktie Foundations is a community based ethno-cultural organization in south east Amsterdam that seeks to research and expand their informal services to connect with and build with professional care organizations. Their aim coincides with this project proposal: promoting health and wellbeing of senior citizens by combining intervention, participatory research and educational perspectives from social work, occupational therapy and hidden voluntary social work. With a boundary crossing innovation of participatory health research, education and Kraktie’s work in the community we co-create, change and innovate towards sustainable interventions with impact.
De chronische longziekte COPD (Chronic Obstructive Pulmonary Disease) kenmerkt zich door een toename van kortademigheid, hoesten en slijmvorming en is een veelvoorkomende ziekte in Nederland. Momenteel zijn er therapieën beschikbaar, waaronder het voorschrijven van een lage onderhoudsdosis Azitromycine, die ervoor zorgt dat het aantal longaanvallen drastisch daalt. De samenstelling van de microbiële populatie (het microbioom) in deze patiëntenpopulatie speelt een belangrijke rol in het ziekteverloop. Microvida analyseert COPD-patiëntmonsters voor het Amphia met behulp van klassieke kweektechnieken en wil nu haar dienstverlening graag uitbreiden. Nieuwe innovatieve ‘next-generation sequencing’ (NGS) maakt het mogelijk om het volledige microbioom van deze patiëntenpopulatie snel en gedetailleerd in kaart te brengen zonder kweek vooraf. Binnen dit project gaan we met een driehoek van MKB-, kennis- en praktijkpartners een high-throughput methode opzetten die het mogelijk maakt het microbioom in sputum snel en gebruiksvriendelijk te analyseren binnen deze patiëntenpopulatie. In het Amphia ziekenhuis loopt momenteel een klinische trial die het veilig afbouwen van het antibioticum Azitromycine onderzoekt en waarbij sputum samples verzameld worden. Met deze samples wordt in dit project een methode opgezet voor het isoleren van zuiver genetisch materiaal alvorens deze samples met behulp van NGS-technieken geanalyseerd worden. Als laatste stap zal een gebruikersinterface ontwikkeld worden die het mogelijk maakt om de verkregen data gebruiksvriendelijk te interpreteren en de resultaten te beoordelen. Alles met uiteindelijke doel meer kennis te vergaren over de samenstelling van het microbioom in relatie tot ziekte en gezondheid van de COPD-patiënt.
Lymphedema is one of the most poorly understood, relatively underestimated and least researched complications of cancer, or its treatment. Lymphedema is a chronic condition that causes abnormal build up of fluid under the skin resulting in painful swelling, commonly in the arms and legs. Limpressive Compression Garments have designed and conceptualised an active and smart compression sleeve that integrates pioneering smart materials and sensor technology to be used to treat and evaluate lymphedema. The Limpressive garments can be used as a research tool while replacing existing compression sleeves and pneumatic compression apparatus. There is currently no product on the market that is integrating both the actuator and sensor technology to treat, let alone quantify lymphedema. It is thus imperative that the Limpressive Compression Garments team are allowed the opportunity through funding to investigate the feasibility of the technology and its integration into healthcare, the business structures and processes needed to enter and be successful in the marketplace and the value to both the consumer and to the organisations dedicated to developing a greater understanding of the disease. Limpressive will complete an extensive and detailed business plan and a complete product design by the end of the Take-off Phase. The business plan and complete product design will be complemented by a proof of function prototype.