BACKGROUND: Consideration of older adults' quality of life (QoL) is becoming increasingly important in the evaluation, quality improvement and allocation of health and social care services. While numerous definitions and theories of QoL have been proposed, an overall synthesis of the perspective of older adults themselves is lacking.METHODS: Qualitative studies were identified in PubMed, Ebsco/Psycinfo and Ebsco/CINAHL, through a search on 28 November 2018. Articles needed to meet all of the following criteria: (i) focus on perceptions of QoL, (ii) older adults living at home as main participants, (iii) use of qualitative methodology, (iv) conducted in a Western country and (v) published in English (vi) not focused on specific patient groups. A thematic synthesis was conducted of the selected studies, using the complete 'findings/results' sections from the papers.RESULTS: We included 48 qualitative studies representing the views of more than 3,400 older adults living at home in 11 Western countries. The QoL aspects identified in the synthesis were categorized into nine QoL domains: autonomy, role and activity, health perception, relationships, attitude and adaptation, emotional comfort, spirituality, home and neighbourhood, and financial security. The results showed that although different domains can be distinguished, these are also strongly connected.CONCLUSION: QoL can be expressed in a number of domains and related subthemes that are important for older adults living at home. The findings further support that the concept of QoL should be seen as a dynamic web of intertwined domains.
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To improve retention rate of factual knowledge for health students we set out to design a game which challenges students to continue testing themselves during their studies. Since we intend for them to play this game for at least two years, we had two major challenges to overcome. Firstly, how can students feel motivated to continue playing for two years on end, and secondly, how can enough content be generated for a two-year game play. The first challenge was solved by tapping into a core motivation of health students: many intend to start their own practice and for that, they want to be involved with other practitioners. We, therefore, proposed a sim-type game in which students cannot just practice on virtual patients but also on practitioners logged in as a patient. The second challenge was tackled by building a flexible framework for case collection, and including the production of those cases in the curricula of the involved programmes.
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This chapter describes the use of a scoring rubric to encourage students to improve their information literacy skills. It will explain how the students apply the rubric to supply feedback on their peers’ performance in information problem solving (IPS) tasks. Supplying feedback appears to be a promising learning approach in acquiring knowledge about information literacy, not only for the assessed but also for the assessor. The peer assessment approach helps the feedback supplier to construct actively sustainable knowledge about the IPS process. This knowledge surpasses the construction of basic factual knowledge – level 1 of the ‘Revised taxonomy of learning objectives’ (Krathwohl, 2002) – and stimulates the understanding and application of the learning content as well as the more complex cognitive processes of analysis, evaluation and creation. This is the author version of a book published by Elsevier. Dit is de auteursversie van een hoofdstuk dat is gepubliceerd bij Elsevier.
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BACKGROUND: One-third of all medication errors causing harm to hospitalized patients occur in the medication preparation and administration phase, which is predominantly a nursing activity. To monitor, evaluate and improve the quality and safety of this process, evidence-based quality indicators can be used.OBJECTIVES: The aim of study was to identify evidence-based quality indicators (structure, process and outcome) for safe in-hospital medication preparation and administration.METHODS: MEDLINE, EMBASE and CINAHL were searched for relevant studies published up to January 2015. Additionally, nine databases were searched to identify relevant grey literature. Two reviewers independently selected studies if (1) the method for quality indicator development combined a literature search with expert panel opinion, (2) the study contained quality indicators on medication safety, and (3) any of the quality indicators were applicable to hospital medication preparation and administration. A multidisciplinary team appraised the studies independently using the AIRE instrument, which contains four domains and 20 items. Quality indicators applicable to in-hospital medication preparation and administration were extracted using a structured form.RESULTS: The search identified 1683 studies, of which 64 were reviewed in detail and five met the inclusion criteria. Overall, according to the AIRE domains, all studies were clear on purpose; most of them applied stakeholder involvement and used evidence reasonably; usage of the indicator in practice was scarcely described. A total of 21 quality indicators were identified: 5 structure indicators (e.g. safety management and high alert medication), 11 process indicators (e.g. verification and protocols) and 5 outcome indicators (e.g. harm and death). These quality indicators partially cover the 7 rights.CONCLUSION: Despite the relatively small number of included studies, the identified quality indicators can serve as an excellent starting point for further development of nursing specific quality indicators for medication safety. Especially on the right patient, right route, right time and right documentation there is room future development of quality indicators.
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INTRODUCTION: The aim of this study was to characterize the epidemiology of severe burns in the Netherlands, including trends in burn centre admissions, non burn centre admissions and differences by age.METHODS: Patients with burn-related primary admission in a Dutch centre from 1995 to 2011 were included. Nationwide prospectively collected data were used from three separate historical databases and the uniform Dutch Burn Repository R3 (2009 onwards). General hospital data were derived from the National Hospital Discharge Register. Age and gender-adjusted rates were calculated by direct standardization, using the 2005 population as the reference standard.RESULTS: The annual number of admitted patients increased from 430 in 1995 to 747 in 2011, incidence rates increased from 2.72 to 4.66 per 100,000. Incidence rates were high in young children, aged 0-4 years and doubled from 10.26 to 22.96 per 100,000. Incidence rates in persons from 5 up to 59 increased as well, in older adults (60 years and older) admission rates were stable. Overall burn centre mortality rate was 4.1%, and significantly decreased over time. There was a trend towards admissions of less extensive burns, median total burned surface area (TBSA) decreased from 8% to 4%. Length of stay and length of stay per percent TBSA decreased over time as well.CONCLUSIONS: Data on 9031 patients admitted in a 17-year period showed an increasing incidence rate of burn-related burn centre admissions, with a decreasing TBSA and decreasing in-burn centre mortality. These data are important for prevention and establishment of required burn care capacity.
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from the repository of Utrecht University: "OBJECTIVES: Antipsychotic drugs are frequently prescribed to elderly patients, but they are associated with serious adverse effects. The objective of the current study was to investigate the association between use of antipsychotics by elderly women and the risk of urinary tract infections (UTIs). COHORT STUDY SETTING: Dispensing data were obtained from the PHARMO Database Network for the period 1998-2008. PARTICIPANTS: Ambulatory Dutch women (≥65 years) with current and past use of antipsychotics. MEASUREMENTS: Incidence rates of UTIs, as defined by use of nitrofurantoin, was calculated within and outside the period of exposure to antipsychotic drugs. Cox proportional hazard regression analysis with Andersen-Gill extension for recurrent events was used to calculate crude and adjusted hazard ratios (HRs). RESULTS: During the study period, 18,541 women with a first prescription of an antipsychotic were identified. Current use of antipsychotics was associated with an increased risk of UTI compared to past use: HR, adjusted for age and history of UTIs, 1.33, 95% CI 1.27-1.39. A strong temporal relationship was found: the risk of being treated for a UTI was higher in the first week after the start of the treatment (adjusted HR 3.03, 95% CI 2.63-3.50) and decreased after 3 months (adjusted HR 1.22, 95% CI 1.17-1.28). Cumulative exposure was not associated with an increased risk of UTIs. There was no difference in effect between conventional and atypical antipsychotics. CONCLUSION: Our results show an increased risk of uncomplicated UTIs during antipsychotic use in older female patients, especially in the first week of treatment."
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Objectives: The aim of this scoping review was threefold: 1. to identify existing definitions of oral frailty and similar terms in gerodontology literature; 2. to assess the oral frailty definitions and analyze whether these are well formulated on a conceptual level; and 3. in the absence of existing definitions meeting the criteria for good conceptual definitions, a new conceptual definition of oral frailty will be presented. Methods: A search was performed in electronic databases and internet search engines. Studies explaining or defining oral frailty or similar terms were of interest. A software-aided procedure was performed to screen titles and abstracts and identify definitions of oral frailty and similar terms. We used a guide to assess the quality of the oral frailty definitions on methodological, linguistic, and content-related criteria. Results: Of the 1,528 screened articles, 47 full-texts were reviewed. Thirteen of these contained seven definitions of oral frailty and ten definitions of similar terms. We found that all definitions of oral frailty contain the same or equivalent characteristics used to define the concepts of ’oral health’, ’deterioration of oral function’, and ’oral hypofunction’. Between the seven definitions, oral frailty is described with a different number and combination of characteristics, resulting in a lack of conceptual consistency. None of the definitions of oral frailty met all criteria. Conclusion: According to our analysis, the current definitions of oral frailty cannot be considered ’good’ conceptual definitions. Therefore, we proposed a new conceptual definition: Oral frailty is the age-related functional decline of orofacial structures.
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The purpose of the research was the development of a questionnaire that can measure the behaviour of groups of students (for instance departments' cohorts) in Personal Information Management (PIM). Variables for the questionnaire were derived from the international literature on PIM. The questionnaire has been tested out on 79 students (last year before graduation) from four different departments of the Academy of ICT&Media at The Hague University of Applied Sciences. The students' responses were checked on consistency, item non response, desirability bias and information value of the results. All these criteria indicated that the questionnaire is an adequate tool for the assessment of PIM at an institutional level. The results that have been found for the four departments have not yet been discussed with the managers of the Academy and those of the individual departments. [De hier gepubliceerde versie is het 'accepted paper' van het origineel dat is gepubliceerd op www.springerlink.com . De officiële publicatie kan worden gedownload op http://www.springerlink.com/content/n0h3k71u85024xnt/]
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Aim: Improvement and harmonization of European clinical pharmacology and therapeutics (CPT) education is urgently required. Because digital educational resources can be easily shared, adapted to local situations and re-used widely across a variety of educational systems, they may be ideally suited for this purpose. Methods: With a cross-sectional survey among principal CPT teachers in 279 out of 304 European medical schools, an overview and classification of digital resources was compiled. Results: Teachers from 95 (34%) medical schools in 26 of 28 EU countries responded, 66 (70%) of whom used digital educational resources in their CPT curriculum. A total of 89 of such resources were described in detail, including e-learning (24%), simulators to teach pharmacokinetics and/or pharmacodynamics (10%), virtual patients (8%), and serious games (5%). Together, these resources covered 235 knowledge-based learning objectives, 88 skills, and 13 attitudes. Only one third (27) of the resources were in-part or totally free and only two were licensed open educational resources (free to use, distribute and adapt). A narrative overview of the largest, free and most novel resources is given. Conclusion: Digital educational resources, ranging from e-learning to virtual patients and games, are widely used for CPT education in EU medical schools. Learning objectives are based largely on knowledge rather than skills or attitudes. This may be improved by including more real-life clinical case scenarios. Moreover, the majority of resources are neither free nor open. Therefore, with a view to harmonizing international CPT education, more needs to be learned about why CPT teachers are not currently sharing their educational materials.
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This speech discusses how the professorship intends to support practitioners in the nursing domain and contribute to shaping nursing leadership and each person's professional individuality. The title of the speech, “Notes on Nursing 2.0,” is particularly intended to emphasize the need for these changes in the nursing domain. Not by assuming that nothing has changed in care and nursing since Nightingale's time. There has. Being educated in the professional domain is not only a given but a requirement. The knowledge domain of care and nursing has developed far and wide in nursing diagnostics and standards. Nursing science research, which Nightingale once started as the first female statistician in the British Kingdom, has firmly established itself in education and practice. Wanting to be of significance to others out of compassion is still the professional motivation, but there is no longer a subservient servitude (Cingel van der, 2012). At the same time, wholehearted leadership is not yet taken for granted in daily practice and optimal professional practice falters due to an equality principle of differently educated caregivers and nurses that has been held for too long. That is the need for change to which this 2.0 version “Notes on Nursing” and the lectorate want to contribute in the coming years. Chapter 1, through the metaphors in the story “The Cat Who Looked at the King,” describes the vision of emancipatory action research and the change principles that the lectorate will deploy. Chapter 2 contains the reason, mission and lines of research that are interrelated within the lectorate. Chapters 3 and 4 address the themes of identity and leadership, discussing their interrelationship with professional practice and developing a research culture. In addition, specific aspects that influence practice and work culture today are addressed, and how the lectorate contributes specifically to the development of nursing leadership and the formation of professional identity in the relevant domain is described. Chapter 5 contains a summary of the principles on which the research program is based, as well as information on current and future projects. Chapter 6 provides background information on the lector and the members of the knowledge circle.
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