Research has shown that some 30% of total care needs in people with late-life depression (LLD) are unmet. It is not known to what extent patients actually don’t receive any care for these needs or consider the care to be insufficient and their satisfaction with the provided care. Results: In 67% of patients, at least one unmet need was ascertained. In most cases (80%) care was actually provided for those needs by professionals and/or informal caregivers. Patients were satisfied with the care delivered for 81% of the reported care needs. Satisfaction was lowest for social care needs (67%). For six specific care needs it was demonstrated that dissatisfied patients were significantly more depressed than satisfied patients. Conclusion: Even though patients might receive care for certain needs, this does not mean that their needs are met. A substantial proportion of patients with LDD feel that they need additional help for unmet needs.
DOCUMENT
Abstract: Background Non-compliance to, or drop-out from treatment for childhood ADHD, result in suboptimal outcome. Non-compliance and drop-out may be due to mismatches between patients’ care needs and treatments provided. This study investigated unmet care needs in ADHD patients. Unmet needs were assessed in two different treatment settings (general outpatient setting versus youth-ACT). Youth-ACT treatment is an intensive outreach-oriented treatment for patients with severe psychiatric and psychosocial problems. Comparison of a general outpatient sample with a youth-ACT sample enabled us to assess the influence of severity of psychiatric and psychosocial problems on perceived care needs. Methods Self-reported unmet care needs were assessed among 105 ADHD patients between 6 and 17 years of age in a general outpatient (n = 52) and a youth-ACT setting (n = 53).
DOCUMENT
Parental involvement is a crucial force in children’s development, learning and success at school and in life [1]. Participation, defined by the World Health Organization as ‘a person’s involvement in life situations’ [2] for children means involvement in everyday activities, such as recreational, leisure, school and household activities [3]. Several authors use the term social participation emphasising the importance of engagement in social situations [4, 5]. Children’s participation in daily life is vital for healthy development, social and physical competencies, social-emotional well-being, sense of meaning and purpose in life [6]. Through participation in different social contexts, children gather the knowledge and skills needed to interact, play, work, and live with other people [4, 7, 8]. Unfortunately, research shows that children with a physical disability are at risk of lower participation in everyday activities [9]; they participate less frequently in almost all activities compared with children without physical disabilities [10, 11], have fewer friends and often feel socially isolated [12-14]. Parents, in particular, positively influence the participation of their children with a physical disability at school, at home and in the community [15]. They undertake many actions to improve their child’s participation in daily life [15, 16]. However, little information is available about what parents of children with a physical disability do to enable their child’s participation, what they come across and what kind of needs they have. The overall aim of this thesis was to investigate parents’ actions, challenges, and needs while enhancing the participation of their school-aged child with a physical disability. In order to achieve this aim, two steps have been made. In the first step, the literature has been examined to explore the topic of this thesis (actions, challenges and needs) and to clarify definitions for the concepts of participation and social participation. Second, for the purposes of giving breadth and depth of understanding of the topic of this thesis a mixed methods approach using three different empirical research methods [17-19], was applied to gather information from parents regarding their actions, challenges and needs.
DOCUMENT
Hematological malignancies and treatment with hematopoietic SCT are known to affect patients’ quality of life. The problem profile and care needs of this patient group need clarification, however. This study aimed to assess distress, problems and care needs after allo- or auto-SCT, and to identify risk factors for distress, problems or care needs. In this cross-sectional study, patients treated with allo-SCT or auto-SCT for hematological malignancies completed the Distress Thermometer and Problem List. Three patient groups were created: 0–1, 1–2.5 and 2.5–5.5 years after transplantation. After allo-SCT, distress and the number of problems tended to be lower with longer follow-up. After auto-SCT, distress was highest at 1–2.5 year(s). Patients mainly reported physical problems, followed by cognitive-emotional and practical problems. A minority reported care needs. Risk factors for distress as well as problems after allo-SCT included younger age, shorter time after transplantation and GVHD. A risk factor for distress as well as problems after auto-SCT was the presence of comorbid diseases. Up to 5 years after auto-SCT or allo-SCT, patients continue to experience distress and problems. Judged by prevalence, physical problems are first priority in supportive care, followed by cognitive-emotional and practical problems.
DOCUMENT
Through a qualitative examination, the moral evaluations of Dutch care professionals regarding healthcare robots for eldercare in terms of biomedical ethical principles and non-utility are researched. Results showed that care professionals primarily focused on maleficence (potential harm done by the robot), deriving from diminishing human contact. Worries about potential maleficence were more pronounced from intermediate compared to higher educated professionals. However, both groups deemed companion robots more beneficiary than devices that monitor and assist, which were deemed potentially harmful physically and psychologically. The perceived utility was not related to the professionals' moral stances, countering prevailing views. Increasing patient's autonomy by applying robot care was not part of the discussion and justice as a moral evaluation was rarely mentioned. Awareness of the care professionals' point of view is important for policymakers, educational institutes, and for developers of healthcare robots to tailor designs to the wants of older adults along with the needs of the much-undervalued eldercare professionals.
DOCUMENT
Background: Nurses play an important role in interprofessional pharmaceutical care. Curricula related to pharmaceutical care, however, vary a lot. Mapping the presence of pharmaceutical care related domains and competences in nurse educational programs can lead to a better understanding of the extent to which curricula fit expectations of the labour market. The aim of this study was to describe 1) the presence of pharmaceutical care oriented content in nursing curricula at different educational levels and 2) nursing students' perceived readiness to provide nurse pharmaceutical care in practice. Methods: A quantitative cross-sectional survey design was used. Nursing schools in 14 European countries offering educational programs for levels 4-7 students were approached between January and April 2021. Through an online survey final year students had to indicate to what extent pharmaceutical care topics were present in their curriculum. Results: A total of 1807 students participated, of whom 8% had level 4-5, 80% level 6, 12% level 7. Up to 84% of the students indicated that pharmaceutical care content was insufficiently addressed in their curriculum. On average 14% [range 0-30] felt sufficiently prepared to achieve the required pharmaceutical care competences in practice. In level 5 curricula more pharmaceutical care domains were absent compared with other levels. Conclusions: Although several pharmaceutical care related courses are present in current curricula of level 4-7 nurses, its embedding should be extended. Too many students perceive an insufficient preparation to achieve pharmaceutical care competences required in practice. Existing gaps in pharmaceutical care should be addressed to offer more thoroughly prepared nurses to the labour market.
DOCUMENT
Purpose Building services technologies such as home automation systems and remote monitoring are increasingly used to support people in their own homes. In order for these technologies to be fully appreciated by the endusers (mainly older care recipients, informal carers and care professionals), user needs should be understood1,2. In other words, supply and demand should match. Steele et al.3 state that there is a shortage of studies exploring perceptions of older users towards technology and the acceptance or rejection thereof. This paper presents an overview of user needs in relation to ambient assisted living (AAL) projects, which aim to support ageing-in-place in The Netherlands. Method A literature survey was made of Dutch AAL projects, focusing on user needs. A total of 7 projects concerned with older persons, with and without dementia, were included in the overview. Results & Discussion By and large technology is considered to be a great support in enabling people to age-in-place. Technology is, therefore, accepted and even embraced by many of the end-users and their relatives. Technology used for safety, security, and emergency response is most valued. Involvement of end-users improves the successful implementation of ambient technology. This is also true for family involvement in the case of persons with dementia. Privacy is mainly a concern for care professionals. This group is also key to successful implementation, as they need to be able to work with the technology and provide information to the end-users. Ambient technologies should be designed in an unobtrusive way, in keeping with indoor design, and be usable by persons with sensory of physical impairments. In general, user needs, particularly the needs of informal carers and care professionals, are an understudied topic. These latter two groups play an important role in implementation and acceptance among care recipients. They should, therefore, deserve more attention from the research community.
LINK
Background: Information is scarce concerning the perceived needs and the amount of health-care utilization of persons with suicidal ideation (SI) compared to those without SI. Aims: To describe the needs and health care use of persons with and without SI and to investigate whether these differences are associated with the severity of the axis-I symptomatology. Method: Data were obtained from 1,699 respondents with a depressive and/or anxiety disorder who participated in the Netherlands Study of Depression and Anxiety. Persons with and without SI were distinguished. Outcome variables were perceived needs and health-care utilization. We used multivariate regression in two models: (1) adjusted only for sociodemographic variables and (2) adjusted additionally for severity of axis-I symptomatology. Results: Persons with SI had higher odds for both unmet and met needs in almost all domains and made more intensive use of mental-health care. Differences in needs and health-care utilization of persons with and without SI were strongly associated with severity of axis I symptomatology. Conclusions: Our results validate previous findings about perceived needs and health-care use of persons with SI. The results also suggest that suicidal persons are more seriously ill, and that they need more professional care, dedication, and specialized expertise than anxious and depressed persons without SI, especially in the domains of information and referral.
MULTIFILE
Malnutrition is a serious and widespread health problem in community-dwelling older adults who receive care in hospital and at home. Hospital and home care nurses and nursing assistants have a key role in the delivery of high-quality multidisciplinary nutritional care. Nursing nutritional care in current practice, however, is still suboptimal, which impacts its quality and continuity. There appear to be at least two reasons for this. First, there is a lack of evidence for nutritional care interventions to be carried out by nurses. Second, there are several factors, that influence nurses’ and nursing assistants’ current behaviour, such as lack of knowledge, moderate awareness of the importance and neutral attitudes. This results in a lack of attention towards nutritional care. Therefore, there is a need to generate more evidence and to focus on targeting the factors that influence nurses’ and nursing assistants’ current behaviour to eventually promote behaviour change. To increase the likelihood of successfully changing their behaviour, an evidence-based educational intervention is appropriate. This might lead to enhancing nutritional care and positively impact nutritional status, health and well-being of community-dwelling older adults. The general objectives of this thesis are: 1) To understand the current state of evidence regarding nutrition-related interventions and factors that influence current behaviour in nutritional care for older adults provided by hospital and home care nurses and nursing assistants to prevent and treat malnutrition. 2) To develop an educational intervention for hospital and home care nurses and nursing assistants to promote behaviour change by affecting factors that influence current behaviour in nutritional care for older adults and to describe the intervention development and feasibility.
DOCUMENT
Background: In order to internalize the midwifery philosophy of care and to learn how to advocate for physiological childbirth, student midwives in the Netherlands need learning experiences that expose them to physiological childbirth practices. Increased hospital births, wide variation in non-urgent referrals and escalating interventions impact on learning opportunities for physiological childbirth. Midwifery educators need to find ways to support student agency in becoming advocates of physiological childbirth. Objective: To gather students’ opinions of what they need to become advocates of physiological childbirth. Methods: Focus groups with student midwives (n = 37), examining attitudes regarding what educational programs must do to support physiological childbirth advocacy. Results: Students reported feelings of personal power when the midwifery philosophy of care is internalized and expressed in practice. Students also identified dilemmas associated with supporting woman-centered care and promoting physiological childbirth. Perceived hierarchy in clinical settings causes difficulties, leading students to practice in accordance with the norms of midwife preceptors. Students are supported in the internalization and realization of the midwifery philosophy of care, including physiological childbirth, if they are exposed to positive examples of care in practice and have opportunities to discuss and reflect on these in the classroom. Key conclusion: Midwifery education should focus on strategies that include navigating dilemmas in practice and helping students to express the midwifery philosophy of care in communication with other professionals and with women. Preceptors need to be supported in allowing student midwives opportunities to realize the midwifery philosophy of care, also when this differs from preceptor practice.
DOCUMENT
