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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:Following the onset of the COVID-19 pandemic, telerehabilitation (TR) has been expanding to address the challenges and risks of in-person delivery. It is likely that a level of TR delivery will continue after the pandemic because of its advantages, such as reducing geographical barriers to service. Many pandemic-related TR initiatives were put in place quickly. Therefore, we have little understanding of current TR delivery, barriers and facilitators, and how therapists anticipate integrating TR into current practice. Knowing this information will allow the incorporation of competencies specifically related to the use and provision of TR into professional profiles and entry-to-practice education, thereby promoting high-quality TR care.Objective:This study aimed to obtain a descriptive overview of current TR practice among rehabilitation therapists in Canada and the Netherlands and identify perceived barriers to and facilitators of practice.Methods:A web-based cross-sectional survey was conducted with occupational, physical, and respiratory therapists and dietitians in Canada (in French and English) and the Netherlands (in Dutch and English) between November 2021 and March 2022. Recruitment was conducted through advertisements on social media platforms and email invitations facilitated by regulatory and professional bodies. The survey included demographic and practice setting information; whether respondents delivered TR, and if so, components of delivery; confidence and satisfaction ratings with delivery; and barriers to and facilitators of use. TR satisfaction and uptake were measured using the Telehealth Usability Questionnaire and modified Technology Acceptance Model. Data were first summarized descriptively, and then, comparisons were conducted between professions.Results:Overall, 723 survey responses were received, mostly from Canada (n=666, 92.1%) and occupational therapists (n=434, 60%). Only 28.1% (203/723) reported receiving specific training in TR, with 1.2% (9/723) indicating that it was part of their professional education. Approximately 19.5% (139/712) reported not using TR at all, whereas most participants (366/712, 51.4%) had been using this approach for 1 to 2 years. Services delivered were primarily teleconsultation and teletreatment with individuals. Respondents offering TR were moderately satisfied with their service delivery and found it to be effective; 90.1% (498/553) indicated that they were likely to continue offering TR after the pandemic. Technology access, confidence, and setup were rated the highest as facilitators, whereas technology issues and the clinical need for physical contact were the most common barriers.Conclusions:Professional practice and experience with TR were similar in both countries, suggesting the potential for common strategic approaches. The high prevalence of current practice and strong indicators of TR uptake suggest that therapists are likely to continue TR delivery after the pandemic; however, most therapists (461/712, 64.7%) felt ill prepared for practice, and the need to target TR competencies during professional and postprofessional education is critical. Future studies should explore best practice for preparatory and continuing education.
The findings suggests that participation in music practices can significantly support caregivers' and nurses' contact with the people to whom they give care and the healthcare professionals' insights into the patients' and residents' personhood. Music can create experienced changes in the care environment through kairotic moments of connectivity and intimacy of the musical interaction. The music sessions support and reinforce the person-centred values of care delivery.The meaning of participatory music practices for the well-being and learning of healthcare professionals working with ageing patients and nursing home residents.