Purpose Incidents of self-injury by forensic psychiatric patients often have a deleterious impact on all those involved. Moreover, self-injurious behaviour is an important predictor for violence towards others during treatment. The aim of this study is to analyse methods and severity of incidents of self-injury of patients admitted to forensic psychiatry, as well as the diagnoses of self-injuring patients. Design/methodology/approach All incidents of self-injury during treatment in a forensic psychiatric centre recorded between 2008 and 2019 were analysed and the severity was coded with the modified observed aggression scale+ (MOAS+). Findings In this period, 299 incidents of self-injury were recorded, displayed by 106 patients. Most of these incidents (87.6%) were classified as non-suicidal. Methods most often used were skin cutting with glass, broken plates, a razor or knife and swallowing dangerous objects or liquids. Ten patients died by suicide, almost all by suffocation with a rope or belt. The majority of the incidents was coded as severe or extreme with the MOAS+. Female patients were overrepresented and they caused on average three times more incidents than male patients. Practical implications More attention is warranted for self-injurious behaviour during forensic treatment considering the distressing consequences for both patients themselves, supervisors and witnesses. Adequate screening for risk of self-injurious behaviour could help to prevent this behaviour. Further research is needed in different forensic settings into predictors of self-injurious behaviour, more specifically, if there are distinct predictors for aggression to others versus to the self. Originality/value Incidents of self-injury occur with some regularity in forensic mental health care and are usually classified as severe. The impact of suicide (attempts) and incidents of self-injurious behaviour on all those involved can be enormous. More research is needed into the impact on all those involved, motivations, precipitants and functions of self-injurious behaviour and effective treatment of it.
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Abstract Background In the Netherlands, palliative care is provided by generalist healthcare professionals (HCPs) if possible and by palliative care specialists if necessary. However, it still needs to be clarifed what specialist expertise entails, what specialized care consists of, and which training or work experience is needed to become a palliative care special‑ist. In addition to generalists and specialists, ‘experts’ in palliative care are recognized within the nursing and medical professions, but it is unclear how these three roles relate. This study aims to explore how HCPs working in palliative care describe themselves in terms of generalist, specialist, and expert and how this self-description is related to their work experience and education. Methods A cross-sectional open online survey with both pre-structured and open-ended questions among HCPs who provide palliative care. Analyses were done using descriptive statistics and by deductive thematic coding of open-ended questions. Results Eight hundred ffty-four HCPs flled out the survey; 74% received additional training, and 79% had more than fve years of working experience in palliative care. Based on working experience, 17% describe themselves as a generalist, 34% as a specialist, and 44% as an expert. Almost three out of four HCPs attributed their level of expertise on both their education and their working experience. Self-described specialists/experts had more working experience in palliative care, often had additional training, attended to more patients with palliative care needs, and were more often physicians as compared to generalists. A deductive analysis of the open questions revealed the similarities and dis‑ tinctions between the roles of a specialist and an expert. Seventy-six percent of the respondents mentioned the impor‑tance of having both specialists and experts and wished more clarity about what defnes a specialist or an expert, how to become one, and when you need them. In practice, both roles were used interchangeably. Competencies for the specialist/expert role consist of consulting, leadership, and understanding the importance of collaboration. Conclusions Although the grounds on which HCPs describe themselves as generalist, specialist, or experts difer, HCPs who describe themselves as specialists or experts mostly do so based on both their post-graduate education and their work experience. HCPs fnd it important to have specialists and experts in palliative care in addition to gen‑eralists and indicate more clarity about (the requirements for) these three roles is needed.
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Introduction: Self-management is considered a potential answer to the increasing demand for family medicine by people suffering from a chronic condition or multi-morbidity. A key element of self-management is goal setting. Goal setting is often defined as a moment of agreement between a professional and a patient. In the self-management literature, however, goal setting is regarded as a circular process. Still, it is unclear how professionals working in family medicine can put it into practice. This background paper aims to contribute to the understanding of goal setting within self-management and to identify elements that need further development for practical use. Debate: Four questions for debate emerge in this article: (1) What are self-management goals? (2) What is necessary to accomplish the process of goal setting within self-management? (3) How can professionals decide on the degree of support needed for goal setting within self-management? (4) How can patients set their goals and how can they be supported? Implications: Self-management goals can be set for different (life) domains. Using a holistic framework will help in creating an overview of patients’ goals that do not merely focus on medical issues. It is a challenge for professionals to coach their patients to think about and set their goals themselves. More insight in patients’ willingness and ability to set self-management goals is desirable. Moreover, as goal setting is a circular process, professionals need to be supported to go through this process with their patients.
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De markt voor gezondheids-apps en ‘wearable’ gezondheidsmeters is enorm in opkomst en brengt veel beloften met zich mee om mensen in beweging te krijgen en gezonde keuzes te laten maken. De meeste van deze toepassingen zijn echter niet gebaseerd op wetenschappelijke methoden over gedragsverandering. Meer inzicht is nodig in de intrinsieke motieven van mensen om deze ICT-technieken al dan niet te gebruiken en effectiever te maken bij het gezond houden van mensen. In deze context wil een samenwerkingsverband van Selfcare BV, een technostarter die een digitaal platform heeft gebouwd waar persoonlijke gezondheidsdata van wearables worden gekoppeld, Fit!vak, de branchevereniging van erkende sport- en bewegingscentra, en het lectoraat Leven Lang in Beweging van Avans Hogeschool, een KIEM project uitvoeren met als centrale onderzoeksvraag hoe gebruikers het gebruik van wearables in combinatie met een digitaal dataplatform ervaren. Het project draagt bij aan de realisatie van het CLICK KIA cross-over programma Create Health. Een onderzoeksteam van Avans Hogeschool volgt gedurende een jaar ca. 60 medewerkers van Avans Hogeschool die een Fitbit sporthorloge in combinatie met het Selfcare dataplatform gebruiken. De uitkomsten van dit verkennend onderzoek zullen worden gebruikt om (voorlopige) aanbevelingen te doen aan de betrokken mkb’ers en een gezamenlijk voorstel voor vervolgonderzoek op te stellen.
A feeling of worry, anxiety, loneliness and anticipation are commonplace in both medical and non-medical arenas such as elderly care. An innovative solution such as the ‘simple and effective’ comfyhand would offer better patient care and improved care efficiency with a high chance of long-term, economic efficiency. ComfyHand is a start-up in the healthcare sector that aims to develop sustainable products to improve patient wellbeing in healthcare settings. It does this by emulating the experience of holding a hand which gives the person comfort and support in moments where real human contact is not possible. Right now the comfyhand is in the development phase, working on several prototypes for test trials in elderly care and hospitals. In this project we want to explore the use of 3D printing for producing a comfyhand. Desired properties for the prototype include optimal heat transfer, softness, regulation of sweat, durability and sustainability. The goal of this study is to develop a prototype to test in a trial with patients within Envida, a care centre. The trial itself is out of scope of this project. This proposal focuses on researching the material of choice and the processability. Building on knowledge gained in a previous Kiem GoChem project and a Use Case (Shape3Dup) of a currently running Raak MKB project (Enlighten) on 3D printing of breast prostheses, several materials, designs and printing parameters will be tested.
Youth care is under increasing pressure, with rising demand, longer waiting lists, and growing staff shortages. In the Netherlands, one in seven children and adolescents is currently receiving youth care. At the same time, professionals face high workloads, burnout risks, and significant administrative burdens. This combination threatens both the accessibility and quality of care, leading to escalating problems for young people and families. Artificial intelligence (AI) offers promising opportunities to relieve these pressures by supporting professionals in their daily work. However, many AI initiatives in youth care fail to move beyond pilot stages, due to barriers such as lack of user acceptance, ethical concerns, limited professional ownership, and insufficient integration into daily practice. Empirical research on how AI can be responsibly and sustainably embedded in youth care is still scarce. This PD project aims to develop practice-based insights and strategies that strengthen the acceptance and long-term adoption of AI in youth care, in ways that support professional practice and contribute to appropriate care. The focus lies not on the technology itself, but on how professionals can work with AI within complex, high-pressure contexts. The research follows a cyclical, participatory approach, combining three complementary implementation frameworks: the Implementation Guide (Kaptein), the CFIR model (Damschroder), and the NASSS-CAT framework (Greenhalgh). Three case studies serve as core learning environments: (1) a speech-to-text AI tool to support clinical documentation, (2) Microsoft Copilot 365 for organization-wide adoption in support teams, and (3) an AI chatbot for parents in high-conflict divorces. Throughout the project, professionals, clients, ethical experts, and organizational stakeholders collaborate to explore the practical, ethical, and organizational conditions under which AI can responsibly strengthen youth care services.
