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Capturing effort and recovery

The effect of family-centered care on unplanned emergency room visits, hospital readmissions and intensive care admissions after surgery

Background: Optimizing transitional care by practicing family-centered care might reduce unplanned events for patients who undergo major abdominal cancer surgery. However, it remains unknown whether involving family caregivers in patients’ healthcare also has negative consequences for patient safety. This study assessed the safety of family involvement in patients’ healthcare by examining the cause of unplanned events in patients who participated in a family involvement program (FIP) after major abdominal cancer surgery. Methods: This is a secondary analysis focusing on the intervention group of a prospective cohort study conducted in the Netherlands. Data were collected from April 2019 to May 2022. Participants in the intervention group were patients who engaged in a FIP. Unplanned events were analyzed, and root causes were identified using the medical version of a prevention- and recovery-information system for monitoring and analysis (PRISMA) that analyses unintended events in healthcare. Unplanned events were compared between patients who received care from family caregivers and patients who received professional at-home care after discharge. A Mann-Whitney U test was used to analyze data. Results: Of the 152 FIP participants, 68 experienced an unplanned event and were included. 112 unplanned events occurred with 145 root causes since some unplanned events had several root causes. Most root causes of unplanned events were patient-related factors (n = 109, 75%), such as patient characteristics and disease-related factors. No root causes due to inadequate healthcare from the family caregiver were identified. Unplanned events did not differ statistically (interquartile range 1–2) (p = 0.35) between patients who received care from trained family caregivers and those who received professional at-home care after discharge. Conclusion: Based on the insights from the root-cause analysis in this prospective multicenter study, it appears that unplanned emergency room visits and hospital readmissions are not related to the active involvement of family caregivers in surgical follow-up care. Moreover, surgical follow-up care by trained family caregivers during hospitalization was not associated with increased rates of unplanned adverse events. Hence, the concept of active family involvement by proficiently trained family caregivers in postoperative care appears safe and feasible for patients undergoing major abdominal surgery.

Gas sensing performance at room temperature of nanogap interdigitated electrodes for detection of acetone at low concentration

From the article: "A facile approach for the fabrication of large-scale interdigitated nanogap electrodes (nanogap IDEs) with a controllable gap was demonstrated with conventional micro-fabrication technology to develop chemocapacitors for gas sensing applications. In this work, interdigitated nanogap electrodes (nanogap IDEs) with gaps from 50–250 nm have been designed and processed at full wafer-scale. These nanogap IDEs were then coated with poly(4-vinyl phenol) as a sensitive layer to form gas sensors for acetone detection at low concentrations. These acetone sensors showed excellent sensing performance with a dynamic range from 1000 ppm to 10 ppm of acetone at room temperature and the observed results are compared with conventional interdigitated microelectrodes according to our previous work. Sensitivity and reproducibility of devices are discussed in detail. Our approach of fabrication of nanogap IDEs together with a simple coating method to apply the sensing layer opens up possibilities to create various nanogap devices in a cost-effective manner for gas sensing applications"

A cross-sectional study of lactation room quality and Dutch working mothers’ satisfaction, perceived ease of, and perceived support for breast milk expression at work

BackgroundThe challenge of combining professional work and breastfeeding is a key reason why women choose not to breastfeed or to stop breastfeeding early. We posited that having access to a high-quality lactation room at the workplace could influence working mothers’ satisfaction and perceptions related to expressing breast milk at work, which could have important longer term consequences for the duration of breastfeeding. Specifically, we aimed to (1) develop a checklist for assessing the quality of lactation rooms and (2) explore how lactation room quality affects lactating mothers’ satisfaction and perceptions. Drawing on social ecological insights, we hypothesized that the quality of lactation rooms (operationalized as any space used for expressing milk at work) would be positively related to mothers’ satisfaction with the room, perceived ease of, and perceived support for milk expression at work.MethodsWe conducted two studies. In Study 1 we developed a lactation room quality checklist (LRQC) and assessed its reliability twice, using samples of 33 lactation rooms (Study 1a) and 31 lactation rooms (Study 1b). Data were collected in the Northern part of the Netherlands (between December 2016 and April 2017). Study 2 comprised a cross-sectional survey of 511 lactating mothers, working in a variety of Dutch organizations. The mothers were recruited through the Facebook page of a popular Dutch breastfeeding website. They completed online questionnaires containing the LRQC and measures aimed at assessing their satisfaction and perceptions related to milk expression at work (in June and July 2017).ResultsThe LRQC was deemed reliable and easy to apply in practice. As predicted, we found that objectively assessed higher-quality lactation rooms were associated with increased levels of satisfaction with the lactation rooms, perceived ease of milk expression at work, and perceived support from supervisors and co-workers for expressing milk in the workplace.ConclusionsThe availability of a high-quality lactation room could influence mothers’ decisions regarding breast milk expression at work and the commencement and/or continuation of breastfeeding. Future studies should explore whether and how lactation room quality affects breastfeeding choices, and which aspects are most important to include in lactation rooms.

Stories of Recovery and Participation. Experiences and challenges.

This publication is a result of an international research project which took place from 2012-2014. Among the participators were four universities, number of service providers, NGOs and people with psychiatric and learning disabilities from Amersfoort and Maastricht in the Netherlands, Budapest in Hungary and Tallinn in Estonia. The aim of the project was to explore the wishes and needs of persons with psychiatric or learning difficulties with regard to community participation, and how services could be (more) supportive in order to meet these needs. We also looked at local policies, especially from the perspective of the UN Convention on the Rights of Persons with Disabilities (CRPD). From the research we learn that regardless of the country where people live, persons with disabilities have similar struggles to cope with vulnerability and deprivation. They also share the same desires as any other human being: the wish to live a good and valued life, to have meaningful activities and to belong to a social community. The stories in this book were selected from the interviews which were conducted by researchers during the project. The portraits illustrate experiences of illness, disability and recovery. They also reflect experiences of using social- and mental health services, exclusion and inclusion. By reading these stories we see, how multifaceted life can be, and what are the challenges towards the real participation in community

Everyday life after a hip fracture

OBJECTIVE: to gain insight into what older adults after hip fracture perceive as most beneficial to their recovery to everyday life.DESIGN: qualitative research approach.SETTING: six skilled nursing facilities.PARTICIPANTS: 19 older community dwelling older adults (aged 65-94), who had recently received geriatric rehabilitation after hip fracture.METHODS: semi-structured interviews were conducted with 19 older adults after hip fracture. Coding techniques based on constructivist grounded theory were applied.RESULTS: four categories were derived from the data: 'restrictions for everyday life', 'recovery process', 'resources for recovery' and 'performing everyday activities'. Physical and psychological restrictions are consequences of hip fracture that older adults have struggled to address during recovery. Three different resources were found to be beneficial for recovery; 'supporting and coaching', 'myself' and 'technological support'. These resources influenced the recovery process. Having successful experiences during recovery led to doing everyday activities in the same manner as before; unsuccessful experiences led to ceasing certain activities altogether.CONCLUSION: participants highlight their own role ('myself') as essential for recovery. Additionally, coaching provides emotional support, which boosts self-confidence in performing everyday activities. Furthermore, technology can encourage older adults to become more active and being engaged in the recovery process. The findings suggest that more attention should be paid to follow-up interventions after discharge from inpatient rehabilitation to support older adults in finding new routines in their everyday activities.A conceptual model is presented and provides an understanding of the participants' experiences and perspectives concerning their process of recovery after hip fracture to everyday life.