Perceptions and values of care professionals are critical in successfully implementing technology in health care. The aim of this study was threefold: (1) to explore the main values of health care professionals, (2) to investigate the perceived influence of the technologies regarding these values, and (3) the accumulated views of care professionals with respect to the use of technology in the future. In total, 51 professionals were interviewed. Interpretative phenomenological analysis was applied. All care professionals highly valued being able to satisfy the needs of their care recipients. Mutual inter-collegial respect and appreciation of supervisors was also highly cherished. The opportunity to work in a careful manner was another important value. Conditions for the successful implementation of technology involved reliability of the technology at hand, training with team members in the practical use of new technology, and the availability of a help desk. Views regarding the future of health care were mainly related to financial cut backs and with a lower availability of staff. Interestingly, no spontaneous thoughts about the role of new technology were part of these views. It can be concluded that professionals need support in relating technological solutions to care recipients' needs. The role of health care organisations, including technological expertise, can be crucial here.
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Despite all improvement initiatives such as the national action plan [De-]Regulate Healthcare by the Dutch Ministry of Health, Welfare and Sport in 2018 to create more time for care within the Netherlands, the administrative burden for care workers is still increasing. Managers of healthcare institutes struggle with efficiently implementing government legislations in day-to-day operations. They indicate that the time spent on administrative tasks demanded by municipalities and national authorities is too much. In addition, they also indicate that there is a lack of consistency and uniformity when it comes to the way care workers handle administrative tasks. This way of working causes additional, and often ad hoc, work in the run-up to an audit. It seems that before laws and regulations are effectively implemented, new laws or regulations again demand attention. This looks like a vicious circle, but research to confirm this is not found yet. Therefore, the following research question is formulated: "What is the impact of laws and regulations on the administrative burden with regard to the primary and supportive processes of Dutch long-term care?" An explanatory multiple case study was conducted to answer the research question. Three case studies were carried out during September 2019 to January 2020. Based on these studies, we have concluded that between 29% and 62% of the total perceived administrative burden by long-term care professionals can be related to legislation.
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Background: A highly promoted opportunity for optimizing healthcare services is to expand the role of nonphysician care providers by care reallocation. Reallocating care from physicians to non-physicians can play an important role in solving systemic healthcare problems such as care delays, hospital overcrowding, long waiting lists, high work pressure and expanding healthcare costs. Dermatological healthcare services, such as the acne care provision, are well suited for exploring the opportunities for care reallocation as many different types of care professionals are involved in the care process. In the Netherlands, acne care is mainly delivered by general practitioners and dermatologists. The Dutch healthcare system also recognizes non-physician care providers, among which dermal therapists and beauticians are the most common professions. However, the role and added value of non-physicians is still unclear. The present study aimed to explore the possibilities for reallocating care to nonphysicians and identify drivers for and barriers to reallocation. Methods: A mixed-method design was used collecting quantitative and qualitative data from representatives of the main 4 Dutch professions providing acne care: dermatologists, GP’s, Dermal therapists and beauticians. Results: A total of 560 questionnaires were completed and 24 semi-structured interviews were conducted. A broad spectrum of non-physician tasks and responsibilities were delineated. Interviewed physicians considered acne as a low-complexity skin condition which made them willing to explore the possibilities for reallocating. A majority of all interviewees saw a key role for non-physicians in counselling and supporting patients during treatment, which they considered an important role for increasing patients’ adherence to proposed treatment regimes, contributing to successful clinical outcome. Also, the amount of time non-physicians spend on patients was experienced as driver for reallocation. Legislation and regulations, uncertainties about the extent of scientific evidence and proper protocols use within the non-physician clinical practice were experienced as barriers influencing the possibilities for reallocation. Conclusions: Delineated roles and drivers demonstrate there is room and potential for reallocation between physicians and non-physicians within acne healthcare, when barriers are adequately addressed.
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Full text via link. De herziening van ons zorgstelsel is in principe een kansrijke innovatie. We maken ons systeem simpeler en brengen het onder regie van het lokale bestuur. Die kan ondersteuning aan burgers slimmer en effectiever organiseren, dichtbij in dorpen en wijken, met meer samenwerking tussen organisaties en professionals. Professionele ondersteuning wordt laagdrempelig, op maat en dicht bij de mensen georganiseerd: Eén huishouden, één plan, één aanpak! Daarbij gaan we uit van de eigen kracht van mensen, van zorgen voor jezelf en voor elkaar. Prachtig allemaal, maar een ingrijpende structuurverandering én een forse bezuiniging (van meer dan 25% op zorguitgaven) én dat alles in korte tijd voor elkaar boksen: die drie elementen leveren scheikundig een op zijn minst broeierig en mogelijk explosief mengsel op.
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In vervolg op onze eerdere publicatie “Werk verandert” (Biemans, Sjoer, Brouwer en Potting, 2017) waarin wij een beeld gaven over het toekomstig werk als verpleegkundige geven wij in deze publicatie een impressie van de ontwikkelingen die spelen bij een viertal specialistische beroepen in zorg en welzijn. Deze vier beroepen zijn achtereenvolgens: de verpleegkundige ouderenzorg, medisch beeldvormings- en bestralingsdeskundige (hierna MBB’er), psychiatrisch verpleegkundige en de maatschappelijk werker.
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Inleiding Het doel van dit vragenlijstonderzoek was om de attitude, kennis, informatiebehoefte en uitvoering van mondgezondheidsbevordering door jeugdartsen en jeugdverpleegkundigen op het consultatiebureau in kaart te brengen. Methode Tien jeugdgezondheidszorginstanties hebben een digitale vragenlijst over kennis, attitude en uitvoering van mondgezondheidsbevordering binnen hun organisatie verspreid. Jeugdartsen en jeugdverpleegkundigen werden gevraagd de vragenlijst in te vullen. Informatie werd verzameld over: 1) demografische kenmerken; 2) kennis over cariësrisicofactoren; 3) attitude ten opzichte van mondgezondheid; 4) uitvoering van mondgezondheidsbevordering tijdens consulten bij kinderen tot vier jaar; en 5) informatiebehoefte. De antwoorden van jeugdartsen en jeugdverpleegkundigen worden apart gepresenteerd. Resultaten Er zijn 146 vragenlijsten van 61 verschillende consultatiebureaus geanalyseerd. Respondenten hadden een positieve attitude en een meerderheid heeft voldoende basale kennis over cariësrisicofactoren. Tijdens een consult verwijst een minderheid (45%) actief naar een mondzorgprofessional voor preventie; 62% kijkt wel eens in de mond van een kind en 36% vindt dat er onvoldoende aandacht is voor mondgezondheidsbevordering op het consultatiebureau. Als reden daarvoor worden tijdsdruk, prioritering van te bespreken onderwerpen en gebrek aan kennis het meest genoemd. Conclusie Ondanks een positieve attitude en basale kennis over cariësrisicofactoren krijgt mondgezondheidsbevordering onvoldoende aandacht op het consultatiebureau. Mondgezondheidsbevordering op consultatiebureaus vraagt om een hogere prioriteit.
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Full text via link. De veronderstelling dat formele zorg zonder meer tegen haar informele variant kan worden uitgeruild en dat de participatiesamenleving maakbaar is, getuigt van een simplistische denkhouding. Sociale innovatie gebaseerd op dergelijke verkeerde aannames is bijzonder risicovol.
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Introduction: Success of e-health relies on the extent to which the related technology, such as the electronic device, is accepted by its users. However, there has been limited research on the patients’ perspective on use of e-health-related technology in rehabilitation care. Objective: To explore the usage of common electronic devices among rehabilitation patients with access to email and investigate their preferences regarding their usage in rehabilitation. Methods: Adult patients who were admitted for inpatient and/or outpatient rehabilitation and were registered with an email address were invited to complete an electronic questionnaire regarding current and preferred use of information and communication technologies in rehabilitation care. Results: 190 out of 714 invited patients completed the questionnaire, 94 (49%) female, mean age 49 years (SD 16). 149 patients (78%) used one or more devices every day, with the most frequently used devices were: PC/laptop (93%), smartphone (57%) and tablet (47%). Patients mostly preferred to use technology for contact with health professionals (mean 3.15, SD 0.79), followed by access to their personal record (mean 3.09, SD 0.78) and scheduling appointments with health professionals (mean 3.07, SD 0.85). Conclusion: Most patients in rehabilitation used one or more devices almost every day and wish to use these devices in rehabilitation. https://doi.org/10.1080/17483107.2017.1358302
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