Background: Patient Reported Experience Measures are promoted to be used as an integrated measurement approach in which outcomes are used to improve individual care (micro level), organisational quality (meso level) and external justification (macro level). However, a deeper understanding of implementation issues of these measures is necessary. The narrative Patient Reported Experience Measure “Dit vind ik ervan!” (English “How I feel about it!”) is used in the Dutch disability care sector, but insight into its’ current use is lacking. We aimed to provide insight into experiences with the implementation and current ways of working with “Dit vind ik ervan!” as an integrated measurement strategy. A descriptive qualitative study was done at a disability care organisation. Data were collected by nine documentations, seven observations, 11 interviews and three focus groups. We applied deductive content analysis using the Consolidated Framework for Implementation Research as a framework. Results: Our analysis revealed facilitators and barriers for the implementation of “Dit vind ik ervan!”. We found most barriers at the micro level. Professionals and clients appreciated the measure’s narrative approach, but struggled to perform it with communication vulnerable clients. Some clients, professionals and team leaders were unfamiliar with the measure’s aim and benefit. On the meso level, implementation was done top-down, and the management’s vision using the measure as an integrated measurement approach was insufficiently shared throughout the organisation. Conclusions: Our study shows that Patient Reported Experience Measures have the potential to be used as an integrated measurement strategy. Yet, we found barriers at the micro level, which might have influenced using the measurement outcomes at the meso and macro level. Tailored implementation strategies, mostly focusing on designing and preparing the implementation on themicro level, need to be developed in co-creation with all stakeholders.
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Background: The integrated uptake of patient-reported experience measures, using outcomes for the micro, meso and macro level, calls for a successful implementation process which depends on how stakeholders are involved in this process. Currently, the impact of stakeholders on strategies to improve the integrated use is rarely reported, and information about how stakeholders can be engaged, including care-users who are communication vulnerable, is limited. This study illustrates the impact of all stakeholders on developing tailored implementation strategies and provides insights into supportive conditions to involve care-users who are communication vulnerable. Methods: With the use of participatory action research, implementation strategies were co-created by care-users who are communication vulnerable (n = 8), professionals (n = 12), management (n = 6) and researchers (n = 5) over 9 months. Data collection consisted of audiotapes, reports, and researchers’ notes. Conventional content analysis was performed. Results: The impact of care-users concerned the strategies’ look and feel, understandability and relevance. Professionals influenced impact on how to use strategies and terminology. The impact of management was on showing the gap between policy and practice, and learning from previous improvement failures. Researchers showed impact on analysis, direction of strategy changes and translating academic and development experience into practice. The engagement of care-users who are communication vulnerable was supported, taking into account organisational issues and the presentation of information. Conclusions: The impact of all engaged stakeholders was identified over the different levels strategies focused on. Care-users who are communication vulnerable were valuable engaged in co-creation implementation strategies by equipping them to their needs and routines, which requires adaptation in communication, delimited meetings and a safe group environment. Trial registration: Reviewed by the Medical Ethics Committee of Zuyderland-Zuyd (METCZ20190006). NL7594 registred at https://www.trialregister.nl/. Plain English summary Exploring care-users experiences is important for decisions to improve quality of care. This applies to care-users in the disability care in particular, as these care-users are highly dependent on their care professional. Instruments that facilitate a dialogue between care-users and care professionals about experiences with care are not always used correctly. Furthermore, it is difficult to translate outcomes into decisions about improving quality of care for the individual care-user and the organisation. In our study, care-users, care professionals, management and researchers developed strategies together to improve the use of care-user experience measures. This study aims to show the impact of all participants, including care-users, professionals, management and researchers, on developing implementation strategies. Additionally, the study aims to show how care-users can participate in developing strategies whilst having problems with communication due to intellectual, developmental and acquired disabilities. We found that care-users gave crucial input to the look and feel, and understandability and relevance of the strategies. The contribution of the professionals had impact on how to use strategies and terminology used in instructions and visuals. Management shared lessons learned and represented the needs on the policy level. Researchers used their analytical skills and facilitated the group process. Care-users were able to collaborate by taking into account their needs and because information was presented to them clearly and attractively.
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Abstract Background: Lifestyle interventions for severe mental illness (SMI) are known to have small to modest efect on physical health outcomes. Little attention has been given to patient-reported outcomes (PROs). Aim: To systematically review the use of PROs and their measures, and quantify the efects of lifestyle interventions in patients with SMI on these PROs. Methods: Five electronic databases were searched (PubMed/Medline, Embase, PsycINFO, CINAHL, and Web of Science) from inception until 12 November 2020 (PROSPERO: CRD42020212135). Randomised controlled trials (RCTs) evaluating the efcacy of lifestyle interventions focusing on healthy diet, physical activity, or both for patients with SMI were included. Outcomes of interest were PROs. Results: A total of 11.267 unique records were identifed from the database search, 66 full-text articles were assessed, and 36 RCTs were included, of which 21 were suitable for meta-analyses. In total, 5.907 participants were included across studies. Lifestyle interventions had no signifcant efect on quality of life (g=0.13; 95% CI=−0.02 to 0.27), with high heterogeneity (I2 =68.7%). We found a small efect on depression severity (g=0.30, 95% CI=0.00 to 0.58, I2 =65.2%) and a moderate efect on anxiety severity (g=0.56, 95% CI=0.16 to 0.95, I2 =0%). Discussion: This meta-analysis quantifes the efects of lifestyle interventions on PROs. Lifestyle interventions have no signifcant efect on quality of life, yet they could improve mental health outcomes such as depression and anxiety symptoms. Further use of patient-reported outcome measures in lifestyle research is recommended to fully capture the impact of lifestyle interventions.
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In this project, we explore how healthcare providers and the creative industry can collaborate to develop effective digital mental health interventions, particularly for survivors of sexual assault. Sexual assault victims face significant barriers to seeking professional help, including shame, self-blame, and fear of judgment. With over 100,000 cases reported annually in the Netherlands the need for accessible, stigma-free support is urgent. Digital interventions, such as chatbots, offer a promising solution by providing a safe, confidential, and cost-effective space for victims to share their experiences before seeking professional care. However, existing commercial AI chatbots remain unsuitable for complex mental health support. While widely used for general health inquiries and basic therapy, they lack the human qualities essential for empathetic conversations. Additionally, training AI for this sensitive context is challenging due to limited caregiver-patient conversation data. A key concern raised by professionals worldwide is the risk of AI-driven chatbots being misused as therapy substitutes. Without proper safeguards, they may offer inappropriate responses, potentially harming users. This highlights the urgent need for strict design guidelines, robust safety measures, and comprehensive oversight in AI-based mental health solutions. To address these challenges, this project brings together experts from healthcare and design fields—especially conversation designers—to explore the power of design in developing a trustworthy, user-centered chatbot experience tailored to survivors' needs. Through an iterative process of research, co-creation, prototyping, and evaluation, we aim to integrate safe and effective digital support into mental healthcare. Our overarching goal is to bridge the gap between digital healthcare and the creative sector, fostering long-term collaboration. By combining clinical expertise with design innovation, we seek to develop personalized tools that ethically and effectively support individuals with mental health problems.
communicative participation, language disordersOBJECTIVE(S)/RESEARCH QUESTION(S) Speech and language therapists (SLTs) are the primary care professionals to treat language and communication disorders. Their treatment is informed by a variety of outcome measures. At present, diagnosis, monitoring of progress and evaluation are often based on performance-based and clinician-reported outcomes such as results of standardized speech, language, voice, or communication tests. These tests typically aim to capture how well the person can produce or understand language in a controlled situation, and therefore only provide limited insight in the person’s challenges in life. Performance measures do not incorporate the unobservable feelings such as a patient's effort, social embarrassment, difficulty, or confidence in communication. Nor do they address language and communication difficulties experienced by the person themselves, the impact on daily life or allow patients to set goals related to their own needs and wishes. The aim of our study is give our patients a voice and empower SLTs to incorporate their patient's perspective in planning therapy. We will Aangemaakt door ProjectNet / Generated by ProjectNet: 08-12-2020 12:072Subsidieaanvraag_digitaal / Grant Application_digitaalDossier nummer / Dossier number: 80-86900-98-041DEFINITIEFdevelop a valid and reliable patient-reported outcome measure that provides information on communicative participation of people with communication disorders and integrate this item bank in patient specific goal setting in speech and language therapy. Both the item bank and the goal setting method will be adapted in cocreation with patients to enable access for people with communication difficulties.STUDY DESIGN Mixed methods research design following the MRC guidance for process evaluation of complex interventions, using PROMIS methodology including psychometric evaluation and an iterative user-centered design with qualitative co-creation methods to develop accessible items and the goal setting method.RESEARCH POPULATION Children, adolescents and adults with speech, language, hearing, and voice disorders.OUTCOME MEASURES An online patient-reported outcome measure on communicative participation, the Communicative Participation Item Bank (CPIB), CPIB items that are accessible for people with language understanding difficulties, a communicative-participation person-specific goal setting method developed with speech and language therapists and patients and tested on usability and feasibility in clinical practice, and a course for SLTs explaining the use of the goal-setting method in their clinical reasoning process.RELEVANCE This study answers one of the prioritized questions in the call for SLTs to systematically and reliably incorporate the clients’ perspective in their daily practice to improve the quality of SLT services. At present patient reported outcomes play only a small role in speech and language therapy because 1) measures (PROMS) are often invalid, not implemented and unsuitable for clinical practice and 2) there is a knowledge gap in how to capture and interpret outcomes from persons with language disorders.
In dit project werkt het lectoraat ‘Bewegen, gezondheid en welzijn’ samen met de Hogeschool Arnhem Nijmegen, Hogeschool Zuyd, de Vrije Universiteit, de Universiteit van Maastricht, het UMC Groningen, drie GGZ instellingen (Universitair Centrum Psychiatrie Groningen (UCP), GGZ Friesland en GGZ Drenthe), de Nederlandse Vereniging voor Psychomotorische Therapie en het Landelijk Platform Geestelijke Gezondheidzorg (LPGGZ, nu ook MIND). De projectdoelstelling is: Het verwerven van nieuwe kennis over de ontwikkeling en implementatie van specifieke uitkomstmaten waarmee de impact van psychomotorische interventies binnen de GGZ gemonitord en geëvalueerd kan worden en de samenwerking met de betrokken patiënt wordt versterkt. Aanleiding voor dit project zijn praktijkvragen van psychomotorisch therapeuten werkzaam in de GGZ. Zij geven aan behoefte te hebben aan nieuwe kennis en meetinstrumenten waarmee ze: 1. het behandelresultaat en de toenemende vraag naar evidentie van psychomotorische therapie (PMT) )vast kunnen stellen; 2. het beloop van de behandeling kunnen monitoren en bespreekbaar kunnen maken met de betrokken patiënt. Op basis van de beschikbare literatuur over behandelevaluaties werd de volgende onderzoeksvraag geformuleerd: ‘Hoe kunnen Patient Reported Outcome Measures (PROMs) voor psychomotorische therapie ontwikkeld en ingezet worden om het specifieke resultaat van psychomotorische therapie bij volwassen patiënten in de GGZ gestandaardiseerd te evalueren en wat kan de bijdrage zijn van dagboekmetingen via Experience Sampling Methods (ESM)?’. Het project richt zich op: 1. Selectie, onderzoek en onderbouwing van PMT specifieke PROMS. 2. Onderzoeken van de haalbaarheid van de inzet van ESM als evaluatiemethode binnen de PMT. 3. De ontwikkeling van een digitale portal. Beoogde resultaten zijn: • Databank van Nederlandstalige meetinstrumenten die als PROMs kunnen dienen ter evaluatie van pychomotorische interventies en die zijn opgenomen in een portal dat beschikbaar komt voor de beroepsgroep. • Handboek over het inzetten van ESM binnen PMT. • Cursussen over het gebruik van de PROMs en het gebruik van ESM.
