Background: Nurses and nursing students experienced an emotional burden while working during the COVID-19 outbreak. During the COVID-19 outbreak three questions for nurses working under these extreme circumstances were formulated: 1. What today’s events do you remember? 2. How do you feel (physically and mentally)? 3. Do you have enough support? The purpose of this study was to obtain insight into whether nurses and nursing students perceive that the use of the three-questions-method contributes to effective coping with the emotional burden during the COVID-19 outbreak. Methods: Focus group interviews were held with hospital nurses (n = 11) and nursing students with internships in mental health care (n = 2), hospital (n = 9), and homecare/nursing home care (n = 3) in September 2020 followed by twenty semi-structured interviews one year later. Results: Almost all nurses and nursing students named factors that contributed to the emotional burden: fear, powerlessness, frustration, lack of knowledge about COVID-19, and pressure to pass the internship. Participants indicated that using the three-questions-method can help to effectively cope with the emotional burden during and after the COVID-19 outbreak. Conclusions: Using the three-questions-method offers added value in coping with emotional burden and can be used in education as well as in practice.
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Background Total laryngectomy with or without adjuvant (chemo)radiation often induces speech, swallowing and neck and shoulder problems. Speech, swallowing and shoulder exercises may prevent or diminish these problems. The aim of the present paper is to describe the study, which is designed to investigate the effectiveness and cost-utility of a guided self-help exercise program built into the application “In Tune without Cords” among patients treated with total laryngectomy. Methods/design Patients, up to 5 years earlier treated with total laryngectomy with or without (chemo)radiation will be recruited for participation in this study. Patients willing to participate will be randomized to the intervention or control group (1:1). Patients in the intervention group will be provided access to a guided self-help exercise program and a self-care education program built into the application “In Tune without Cords”. Patients in the control group will only be provided access to the self-care education program. The primary outcome is the difference in swallowing quality (SWAL-QOL) between the intervention and control group. Secondary outcome measures address speech problems (SHI), shoulder disability (SDQ), quality of life (EORTC QLQ-C30, QLQ-H&N35 and EQ-5D), direct and indirect costs (adjusted iMCQ and iPCQ measures) and self-management (PAM). Patients will be asked to complete these outcome measures at baseline, immediately after the intervention or control period (i.e. at 3 months follow-up) and at 6 months follow-up. Discussion This randomized controlled trial will provide knowledge on the effectiveness of a guided self-help exercise program for patients treated with total laryngectomy. In addition, information on the value for money of such an exercise program will be provided. If this guided self-help program is (cost)effective for patients treated with total laryngectomy, the next step will be to implement this exercise program in current clinical practice.
Zorgcapaciteit kan een belangrijke schakel zijn tussen multi-probleem omstandigheden en ongunstige ontwikkeling van kinderen. Deze studie heeft als doel om de zorgcapaciteit en de correlaties daartussen te onderzoeken in zeer kwetsbare multiprobleemgezinnen in Rotterdam, Nederland. Zorgcapaciteit (algemeen, emotioneel en instrumenteel) werd prospectief beoordeeld bij 83 zeer kwetsbare vrouwen met behulp van video-observaties van dagelijkse zorgtaken, zes weken postpartum. Ondersteunende gegevens werden verzameld op drie tijdstippen: bij inclusie, zes weken na inclusie en zes weken postpartum, en deze omvatten psychologische symptomen, zelfredzaamheid, problematische levensdomeinen, thuisomgeving, inkomen, depressie, angst en stress. Zwangerschaps- en bevallingsgerelateerde informatie werd verzameld bij verloskundigen. De scores voor zorgverlening door de moeder waren gemiddeld van onvoldoende kwaliteit. Moeders die in een onveilige thuisomgeving leefden (B = 0,62) en moeders met meer problematische levensdomeinen (≤3 domeinen, B = 0,32) vertoonden significant hogere instrumentele zorgcapaciteiten. Andere variabelen waren niet gerelateerd aan zorgcapaciteit. De zorgcapaciteit in deze zeer kwetsbare populatie was van onvoldoende kwaliteit. In de meeste gevallen was er echter geen significant verband tussen zorgzaamheid en de variabelen die gerelateerd zijn aan kwetsbaarheid. Dit betekent dat een mogelijk verband tussen kwetsbaarheid en zorgcapaciteit kan worden veroorzaakt door de interactie tussen verschillende problemen, in plaats van door het type of de omvang van de zorg.
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