Deze scriptie is het resultaat van de postdoctorale opleiding van het TIAS Management van Leren en Ontwikkeling, waarin het leren en het ontwikkelen van individuen, groepen en organisaties centraal staan. In de scriptie wordt de dialoog als kritische succesfactor voor organisaties in verandering beschreven. Dialoog is de interactie,reflectie en constructie die moet leiden tot gemeenschappelijke taal en betekeningeving. dialoog leidt tot vergroting van het leervermogen van individuen, groepen en organisaties.
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Background: Insufficient amounts of physical activity is a risk factor for (recurrent) stroke. People with a stroke or transient ischemic attack (TIA) have a high risk of recurrent stroke and have lower levels of physical activity than their healthy peers. Though several reviews have looked at the effects of lifestyle interventions on a number of risk factors of recurrent stroke, the effectiveness of these interventions to increase the amounts of physical activity performed by people with stroke or TIA are still unclear. Therefore, the research question of this study was: what is the effect of lifestyle interventions on the level of physical activity performed by people with stroke or TIA? Method: A systematic review was conducted following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Pubmed, Embase and Cumulative Index for Nursing and Allied Health Literature (CINAHL), were searched up to August 2018. Randomised controlled trials that compared lifestyle interventions, aimed to increase the amount of physical activity completed by participants with a stroke or TIA, with controls were included. The Physiotherapy Evidence Database (PEDro) score was used to assess the quality of the articles, and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) method for the best evidence synthesis. Results: Eleven trials (n = 2403) met the inclusion criteria. The quality of the trials was mostly high, with 8 (73%) of trials scoring ≥6 on the PEDro scale. The overall best evidence syntheses showed moderate quality evidence that lifestyle interventions do not lead to significant improvements in the physical activity level of people with stroke or TIA. There is low quality evidence that lifestyle interventions that specifically target physical activity are effective at improving the levels of physical activity of people with stroke or TIA. Conclusion: Based on the results of this review, general lifestyle interventions on their own seem insufficient in improving physical activity levels after stroke or TIA. Lifestyle interventions that specifically encourage increasing physical activity may be more effective. Further properly powered trials using objective physical activity measures are needed to determine the effectiveness of such interventions.
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Full text via link. Veel organisaties hebben de afgelopen jaren geëxperimenteerd met nieuwe organisatie- en arbeidsvormen die zorgmedewerkers meer professionele autonomie moeten geven. Zo ook De Vriezenhof, een kleinschalig woon- en zorgcentrum in Vriezenveen, dat daarbij werd geïnspireerd door het voorbeeld van pioniers als BuurtZorg. Met behulp van een door de Hogeschool Utrecht ontwikkelde bottom-up verandermethode wil De Vriezenhof de kwaliteit van de zorg en van het werk verbeteren.
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