Zoekresultaten

Health literacy: naar moderne dynamische communicatie

De duurzaamheid van e-health toepassingen: een broos complex samenspel

Gezocht: interdisciplinary oriented frontline health worker

Article in Dutch addressing the importance of interdisciplinary cooperation with professionals and family members.

Development and usability of the MAINtAIN, an inventory assessing nursing staff behavior to optimize and maintain functional activity among nursing home residents

Background: Functional decline is common in nursing home residents. Nursing staff can help prevent this decline, by encouraging residents to be more active in functional activities. Questionnaires measuring the extent to which nursing staff encourage functional activity among residents are lacking. In addition, there are no measurement instruments to gain insight into nursing staff perceived barriers and facilitators to this behavior. The aim of this study was to develop, and study the usability, of the MAastrIcht Nurses Activities INventory (MAINtAIN), an inventory assessing a) the extent to which nursing staff perceive to perform behaviors that optimize and maintain functional activity among nursing home residents and b) the perceived barriers and facilitators related to this behavior. Methods: Using a mixed-methods approach the MAINtAIN was developed and its usability was studied. Development was based on literature, expert opinions, focus group (N = 3) and individual interviews (N = 14) with residents and staff from nine nursing homes in the Netherlands. Usability was studied in a cross-sectional study with 37 nurses and certified nurse assistants; data were analyzed using descriptive statistics. Results: Development of the MAINtAIN resulted in two distinctive parts: MAINtAIN-behaviors and MAINtAIN-barriers. MAINtAIN-behaviors, targeting nursing staff behavior to optimize and maintain functional activity, includes 19 items covering activities of daily living, household activities, and miscellaneous activities. MAINtAIN-barriers addresses the perceived barriers and facilitators related to this behavior and comprises 33 items covering barriers and facilitators related to the residents, the professionals, the social context, and the organizational and economic context. The usability study showed that the inventory was not difficult to complete, that items and response options were clear,and that the number of missing values was low. Few items showed a floor or ceiling effect. Conclusions: The newly developed inventory MAINtAIN provides a usable method for researchers and nursing homes to obtain insight into nursing staff perceived behavior in optimizing functional activity among residents and their perceived barriers and facilitators related to this behavior. Outcomes of the MAINtAIN may contribute to change in nursing staff behavior and may improve nursing care. Further research with regard to the psychometric properties of the MAINtAIN is recommended.

Functioning assessment vs. conventional medical assessment: a comparative study on health professionals’ clinical decision-making and the fit with patient’s own perspective of health

Aims and objectives. To compare a functioning assessment based on the International Classification of Functioning, Disabilityand Health (ICF) with a conventional medical assessment, in terms of their respective consequences for health professionals’clinical decision-making and the fit with patient’s own perspective of health.Background. In chronic diseases, pathogenic-oriented health care falls short in generating all the information required fordetermining healthcare provision to improve health. A broader, so-called salutogenic approach, by using the ICF, focusingon how to stay healthy, rather than on what causes diseases, seems more appropriate.Design. A cross-sectional comparative study using data from a randomised controlled trial.Methods. Data about patient problems and professional healthcare activities were collected from a total of 81 patients withsevere multiple sclerosis who were randomly assigned to one of two groups: the ICF group, assessed with a functioningassessment (n = 43), and the medical group, assessed with a conventional medical assessment (n = 38). Data were analysedstatistically using descriptive and inferential statistics.Results. A functioning assessment resulted in the registration of significantly more patient problems in the health components‘participation’ and ‘environmental factors’, as well as significantly more professional healthcare activities befitting thesecomponents. The ICF group had a significant positive correlation between registered problems by health professionals andpatients’ self-reported problems, whereas the medical group had several negative correlations.Conclusion. A functioning assessment resulted in a care plan that not only was broader and more complete but also reflectedthe patients’ self-reported problems more closely than a medical assessment, without a loss of focus on medical problems.Relevance to clinical practice. This study has shown that some health problems remain unnoticed by a medical assessmentalone, which is especially important for the chronically ill. A functioning assessment provides a strong foundation for identifyingall relevant information related to health.

Do nursing staff encourage functional activity among nursing home residents?

BACKGROUND: Nursing home residents are mainly inactive. Nursing staff can encourage residents to perform functional activities during daily care activities. This study examines 1) the extent to which nursing staff perceive that they encourage functional activity in nursing home residents and 2) the associations between these nursing behaviors and professional characteristics, contextual factors, and information-seeking behaviors. METHODS: In this cross-sectional study, 368 registered nurses and certified nurse assistants, working in somatic and psychogeriatric wards of forty-one nursing homes throughout the Netherlands participated. Self-reported data were collected with a questionnaire, comprising the MAINtAIN-behaviors, which assesses the extent to which nursing staff encourage functional activities, including different activities of daily living (ADL), household activities, and miscellaneous encouraging activities (e.g., discouraging informal caregivers from taking over activities residents can do themselves). Additional data collected included professional characteristics (e.g., age), contextual factors (e.g., ward type), and information-seeking behaviors (e.g., reading professional journals). Descriptive statistics were used to determine the extent to which functional activities were encouraged. Hierarchical linear regression analyses were performed to determine the associations between the encouragement of functional activities and other factors. RESULTS: Nursing staff perceived that household activities (mean 4.1 (scale range 1-9), SD 1.9) were less often encouraged than ADL (mean 6.9, SD 1.2) or miscellaneous activities (mean 6.7, SD 1.5). The percentage of nursing staff stating that different household activities, ADL, or miscellaneous activities were almost always encouraged ranged from 11 to 45%, 41 to 86%, and 50 to 83% per activity, respectively. The extent to which these activities were encouraged differed for some of the professional characteristics, contextual factors, or information-seeking behaviors, but no consistent pattern in associations emerged. CONCLUSIONS: According to nursing staff, household activities are not as often encouraged as ADL or miscellaneous activities. Professional characteristics, contextual factors, and information-seeking behaviors are not consistently associated with the encouragement of functional activity. Nursing staff should also focus on improving the encouragement of household activities. Future research could examine the role of other factors in encouraging functional activity, such as experienced barriers, and assess to what extent the perception of nursing staff corresponds with their actual behavior.