Objective: To evaluate the preliminary effectiveness of a goal-directed movement intervention using a movement sensor on physical activity of hospitalized patients. Design: Prospective, pre-post study. Setting: A university medical center. Participants: Patients admitted to the pulmonology and nephrology/gastro-enterology wards. Intervention: The movement intervention consisted of (1) self-monitoring of patients' physical activity, (2) setting daily movement goals and (3) posters with exercises and walking routes. Physical activity was measured with a movement sensor (PAM AM400) which measures active minutes per day. Main measures: Primary outcome was the mean difference in active minutes per day pre- and post-implementation. Secondary outcomes were length of stay, discharge destination, immobility-related complications, physical functioning, perceived difficulty to move, 30-day readmission, 30-day mortality and the adoption of the intervention. Results: A total of 61 patients was included pre-implementation, and a total of 56 patients was included post-implementation. Pre-implementation, patients were active 38 ± 21 minutes (mean ± SD) per day, and post-implementation 50 ± 31 minutes per day (Δ12, P = 0.031). Perceived difficulty to move decreased from 3.4 to 1.7 (0-10) (Δ1.7, P = 0.008). No significant differences were found in other secondary outcomes. Conclusions: The goal-directed movement intervention seems to increase physical activity levels during hospitalization. Therefore, this intervention might be useful for other hospitals to stimulate inpatient physical activity.
Objective: To construct the underlying value structure of shared decision making (SDM) models. Method: We included previously identified SDM models (n = 40) and 15 additional ones. Using a thematic analysis, we coded the data using Schwartz’s value theory to define values in SDM and to investigate value relations. Results: We identified and defined eight values and developed three themes based on their relations: shared control, a safe and supportive environment, and decisions tailored to patients. We constructed a value structure based on the value relations and themes: the interplay of healthcare professionals’ (HCPs) and patients’ skills [Achievement], support for a patient [Benevolence], and a good relationship between HCP and patient [Security] all facilitate patients’ autonomy [Self-Direction]. These values enable a more balanced relationship between HCP and patient and tailored decision making [Universalism]. Conclusion: SDM can be realized by an interplay of values. The values Benevolence and Security deserve more explicit attention, and may especially increase vulnerable patients’ Self-Direction. Practice implications: This value structure enables a comparison of values underlying SDM with those of specific populations, facilitating the incorporation of patients’ values into treatment decision making. It may also inform the development of SDM measures, interventions, education programs, and HCPs when practicing.
Background: Despite the compelling case for engaging parents in speech and language therapy, research indicates that speech and language therapists (SLTs) currently have a leading role in the goal-setting process of therapy for children with developmental language disorder (DLD). Therefore, we set out to develop a tool that aims to support the dialogue between SLTs and parents and enhance shared decision-making about children's communicative participation goals. We used co-design techniques with SLT–practitioners to include their perspectives throughout the design process. Although co-design has been used for some years in healthcare research, it is still a relatively new research methodology in the field of speech and language therapy. Aims: To provide a detailed description of the co-design process that led to the development of a physical artefact that can support SLTs to engage parents of children with DLD in collaborative goal-setting. Methods & Procedures: The Design Council's Double Diamond model was used to develop a tool in co-design, together with eight SLTs, who participated in all stages of the development process. Usability was tested in actual goal-setting conversations between four SLTs and 11 parents of a child with DLD resulting in stepwise improvements. In addition, usability of the first and final prototypes was tested with five usability criteria that were rated on a 10-point scale by 64 SLTs. Outcomes & Results: The co-design process resulted in the development of a physical prototype of the tool called ‘ENGAGE’, consisting of a metal ‘tree trunk’ on which parents can stick magnetic ‘leaves’ containing potential participation goals for their child. The ‘tree’ shape represents a child's development and opportunities for growth. This first prototype received marks between 7.0 and 8.0 out of 10 on attractiveness, user-friendliness, safety, functionality and affordability. After several iterations, there were significantly higher marks for attractiveness, user-friendliness and safety in favour for the final prototype. Marks for functionality and affordability did not change significantly. Conclusions & Implications: As researchers we usually develop pen-and-paper tools, interview protocols, apps or questionnaires to support clinical practice. Including the SLTs’ perspectives in the design process resulted in a tree-shaped physical artefact that, according to the SLTs, helps to order information and encourages and guides their dialogue with parents. We strongly advocate the inclusion of end-users in developing innovative user-centred tools for speech and language therapy and we hope that this will become widespread practice.
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Om de ambities te behalen zoals geformuleerd in de Sustainable Development Goals, is transdisciplinaire samenwerking nodig tussen overheden, bedrijfsleven, burgers en wetenschap. Dit vraagt om multi-stakeholderbenaderingen waarin leren van en met elkaar centraal staat. Dit onderzoeksvoorstel is een vertaalslag van bovenstaande ambitie zoals geformuleerd in samenwerking met hoger onderwijs partners in Bandung, Indonesië. Het Living Lab Upper Citarum biedt een context om onderzoek te doen binnen een bestaand Living Lab gekenmerkt door de multi-stakeholder setting en de complexiteit van duurzaam beheer van natuurlijke hulpbronnen. Het onderzoek beoogt inzicht te verkrijgen in essentiële ‘21st century skills’ voor deelnemers met faciliterende rollen in een Living Lab. De onderzoeksstrategie wil een bijdrage leveren aan de duurzaamheidsagenda van Living Labs met het ontwerpen, het ervaren, reflecteren en documenteren van praktische interventies in de lokale context. De keuze voor werken op locatie is een eerste benadering in het creëren van een realistische leerervaring voor Living Lab facilitators met diverse achtergronden en valt daarmee te beschrijven als ‘learning by doing’. De algemene onderzoekvraag is als volgt geformuleerd: Which contemporary skills and capabilities are present and which need to be developed to establish a widely shared mind set for trans- or interdisciplinary strategies so that communities and institutions in a Living Lab configuration increase their performance? De onderzoeksstrategie krijgt vorm in een ‘21st century skills exploration’ die een experimentele leerruimte biedt aan medewerkers van diverse instituten en (overheids-)organisaties die actief zijn in het Living Lab om kennis te maken met de creatieve methodes voor publieke participatie. Dit vindt vooral plaats in interactie met lokale gemeenschappen met nadruk op creatieve methodes zoals een poetry route, participatory mapping en film. Na presentatie op locatie worden de resultaten gepresenteerd tijdens een mini-symposium in Bandung.
