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.
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Background: Recent technological developments such as wearable sensors and tablets with a mobile internet connection hold promise for providing electronic health home-based programs with remote coaching for patients following total hip arthroplasty. It can be hypothesized that such a home-based rehabilitation program can offer an effective alternative to usual care.Objective: The aim of this study was to determine the effectiveness of a home-based rehabilitation program driven by a tablet app and remote coaching for patients following total hip arthroplasty.Methods: Existing data of two studies were combined, in which patients of a single-arm intervention study were matched with historical controls of an observational study. Patients aged 18-65 years who had undergone total hip arthroplasty as a treatment for primary or secondary osteoarthritis were included. The intervention consisted of a 12-week home-based rehabilitation program with video instructions on a tablet and remote coaching (intervention group). Patients were asked to do strengthening and walking exercises at least 5 days a week. Data of the intervention group were compared with those of patients who received usual care (control group). Effectiveness was measured at four moments (preoperatively, and 4 weeks, 12 weeks, and 6 months postoperatively) by means of functional tests (Timed Up & Go test and the Five Times Sit-to Stand Test) and self-reported questionnaires (Hip disability and Osteoarthritis Outcome Score [HOOS] and Short Form 36 [SF-36]). Each patient of the intervention group was matched with two patients of the control group. Patient characteristics were summarized with descriptive statistics. The 1:2 matching situation was analyzed with a conditional logistic regression. Effect sizes were calculated by Cohen d.Results: Overall, 15 patients of the intervention group were included in this study, and 15 and 12 subjects from the control group were matched to the intervention group, respectively. The intervention group performed functional tests significantly faster at 12 weeks and 6 months postoperatively. The intervention group also scored significantly higher on the subscales "function in sport and recreational activities" and "hip-related quality of life" of HOOS, and on the subscale "physical role limitations" of SF-36 at 12 weeks and 6 months postoperatively. Large effect sizes were found on functional tests at 12 weeks and at 6 months (Cohen d=0.5-1.2), endorsed by effect sizes on the self-reported outcomes.Conclusions: Our results clearly demonstrate larger effects in the intervention group compared to the historical controls. These results imply that a home-based rehabilitation program delivered by means of internet technology after total hip arthroplasty can be more effective than usual care.Keywords: home-based rehabilitation program; internet; osteoarthritis; physiotherapy; rehabilitation; remote coaching; tablet app; total hip arthroplasty; total hip replacement; usual care.
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PurposeThe Optimal Physical Recovery After Hospitalization (OPRAH) Intervention is a blended intervention, combining a smartphone app for self-monitoring of physical activity and protein intake with coaching from a physiotherapist and dietician, to enhance the functional recovery after gastro-intestinal or lung cancer surgery. The aim was to evaluate patients’ experiences with the OPRAH intervention.MethodsThis study used a multi-method approach, incorporating semi-structured interviews and an online questionnaire. The questionnaire included the System Usability Scale (SUS) to evaluate the smartphone app. Sixty-eight patients were invited to complete the online survey, 58 providing responses. Purposeful sampling guided the selection of participants for interviews (n = 24), which focused on experiences with the application, activity tracker, and remote coaching. The interview data were analyzed qualitatively using an inductive thematic approach.ResultsThe app was rated with an excellent usability (mean ± SD SUS of 86.2 ± 12.0) and 97% of the patients would recommend the intervention to others. Patients reported that the intervention enhanced their understanding of their recovery process, motivated them to achieve protein and physical activity goals, and contributed to their overall recovery. The combination of app usage and monitoring by a physiotherapist and dietician fostered a sense of being supported. However, patients suggested that the intervention could be improved by further tailoring it to individual needs, detailing the nutritional component of the app, and redesigning the activity tracker bracelet.ConclusionsThe OPRAH intervention demonstrated excellent system usability and predominantly positive experiences. Incorporating patient recommendations could further support its integration into regular healthcare.
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In this article, the outcomes of a survey aimed to investigate how aware of and how capable coaches in higher vocational Dutch education perceive themselves to assist students displaying mental health and well-being issues are presented. Additionally, the article explores coaches’ perceptions regarding the frequency, form of help offered, topics to be tackled and the preferred form in which this help should be provided. The author conducted a survey that gathered qualitative and quantitative data from coaches (N 5 82) at a Dutch University of Applied Sciences in the north of the Netherlands. A differentiation in coaches’ number of years of teaching and coaching experience was considered.
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Purpose: To systematically review the literature on effectiveness of remote physiotherapeutic e-Health interventions on pain in patients with musculoskeletal disorders. Materials and methods: Using online data sources PubMed, Embase, and Cochrane in adults with musculoskeletal disorders with a pain-related complaint. Remote physiotherapeutic e-Health interventions were analysed. Control interventions were not specified. Outcomes on effect of remote e-Health interventions in terms of pain intensity. Results: From 11,811 studies identified, 27 studies were included. There is limited evidence for the effectiveness for remote e-Health for patients with back pain based on five articles. Twelve articles studied chronic pain and the effectiveness was dependent on the control group and involvement of healthcare providers. In patients with osteoarthritis (five articles), total knee surgery (two articles), and knee pain (three articles) no significant effects were found for remote e-Health compared to control groups. Conclusions: There is limited evidence for the effectiveness of remote physiotherapeutic e-Health interventions to decrease pain intensity in patients with back pain. There is some evidence for effectiveness of remote e-Health in patients with chronic pain. For patients with osteoarthritis, after total knee surgery and knee pain, there appears to be no effect of e-Health when solely looking at reduction of pain. Implications for rehabilitation This review shows that e-Health can be an effective way of reducing pain in some populations. Remote physiotherapeutic e-Health interventions may decrease pain intensity in patients with back pain. Autonomous e-Health is more effective than no treatment in patients with chronic pain. There is no effect of e-Health in reduction of pain for patients with osteoarthritis, after total knee surgery and knee pain.Implications for rehabilitation* This review shows that e-Health can be an effective way of reducing pain in some populations.* Remote physiotherapeutic e-Health interventions may decrease pain intensity in patients with back pain.* Autonomous e-Health is more effective than no treatment in patients with chronic pain.* There is no effect of e-Health in reduction of pain for patients with osteoarthritis, after total knee surgery and knee pain.
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New Virtual Care Centers (VCCs) within hospitals utilize information technology to remotely monitor and support patients with chronic diseases living at home. Nurses play a crucial role by providing remote coaching and guidance to help patients manage their conditions. Currently, there is a growing understanding regarding the evolving roles and responsibilities of nurses in VCCs, however studies have yet to establish connections with educational frameworks, which poses a challenge for nursing education programs to prepare students for this emerging professional role effectively. Our study aimed to provide insights into the evolving roles, tasks, and responsibilities of nurses providing remote care as per the CanMEDS framework. We conducted a qualitative content analysis of 15 interviews. Nursing work within VCCs is represented by the seven CanMEDS roles. Most tasks align with the roles of Leader and Collaborator, while Quality Promotor has the fewest. Our study maps the responsibilities and tasks of VCCs' care delivery to the core roles of nurses.
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Among runners, there is a high drop-out rate due to injuries and loss of motivation. These runners often lack personalized guidance and support. While there is much potential for sports apps to act as (e-)coaches to help these runners to avoid injuries, set goals, and maintain good intentions, most available running apps primarily focus on persuasive design features like monitoring, they offer few or no features that support personalized guidance (e.g., personalized training schemes). Therefore, we give a detailed description of the working mechanism of Inspirun e-Coach app and on how this app uses a personalized coaching approach with automatic adaptation of training schemes based on biofeedback and GPS-data. We also share insights into how end-users experience this working mechanism. The primary conclusion of this study is that the working mechanism (if provided with accurate data) automatically adapts training sessions to the runners’ physical workload and stimulates runners’ goal perception, motivation, and experienced personalization. With this mechanism, we attempted to make optimal use of the potential of wearable technology to support the large group of novice or less experienced runners and that by providing insight in our working mechanisms, it can be applied in other technologies, wearables, and types of sports.
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Providing high-quality feedback is essential for improving preservice teacher performance. Rather than post-lesson feedback, immediate performance feedback while teaching is considered effective. This article reports on developing and piloting a standardised tool for synchronous feedback. Eight teacher educators from a Dutch higher education institution were trained to use the tool (based on accepted models of teacher roles, observation criteria and feedback levels) with pre-recorded lessons. Interobserver reliability was good for teacher roles and sufficient for feedback levels. Positive evaluations of the tool and educators’ interest in its application, warrant further research into scalability and effectiveness of synchronous feedback delivery.
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In dit abstract wordt de ontwikkeling van een online onderwijsmodule beschreven gericht op eHealth voor leefstijlverbetering
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BackgroundPhysical activity can prevent or delay age-related impairments and prolong the ability of older adults to live independently. Community-based programs typically offer classes where older adults can exercise only once a week under the guidance of an instructor. The health benefits of such programs vary. Exercise frequency and the duration of the program play a key role in realizing effectiveness. An auxiliary home-based exercise program can provide older adults the opportunity to exercise more regularly over a prolonged period of time in the convenience of their own homes. Furthermore, mobile electronic devices can be used to motivate and remotely guide older adults to exercise in a safe manner. Such a blended intervention, where technology is combined with personal guidance, needs to incorporate behavior change principles to ensure effectiveness.ObjectiveThe aim of this study was to identify theory-based components of a blended intervention that supports older adults to exercise at home.MethodsThe Medical Research Council framework was used to develop the blended intervention. Insights from focus group, expert panels, and literature were combined into leading design considerations.ResultsA client-server system had been developed that combined a tablet app with a database in the cloud and a Web-based dashboard that can be used by a personal coach to remotely monitor and guide older adults. The app contains several components that facilitate behavior change—an interactive module for goal setting, the ability to draw up a personal training schedule from a library containing over 50 exercise videos, progress monitoring, and possibilities to receive remote feedback and guidance of a personal coach.ConclusionsAn evidence-based blended intervention was designed to promote physical activity among older adults. The underlying design choices were underpinned by behavior change techniques that are rooted in self-regulation. Key components of the tablet-supported intervention were a tailored program that accommodates individual needs, demonstrations of functional exercises, monitoring, and remote feedback. The blended approach combines the convenience of a home-based exercise program for older adults with the strengths of mobile health and personal guidance.
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