Assistive Technology (AT) is any technology that supports people with functional difficulties to perform their daily activities with less difficulty and/or obstruction, thus contributing to a more fulfilling life. This refers to people of all ages and to all kinds of functional limitations, either permanent or temporary. Assistive products can be traditional physical products, such as wheelchairs, eyeglasses, hearing aids, or prostheses, but they can also be special input devices, care robots, computers with accessible software, apps for smartphones, home automation solutions, virtual realities, etc. It is essential to understand that AT involves more than just familiar products, and that it also includes knowledge about the personalized selection of appropriate solutions, provisions, and services, as well as the training of all parties involved, the measurement of outcomes and impacts, awareness of ethical issues, etc.
DOCUMENT
Objective: To obtain insight into (a) the prevalence of nursing staff–experienced barriers regarding the promotion of functional activity among nursing home residents, and (b) the association between these barriers and nursing staff–perceived promotion of functional activity. Method: Barriers experienced by 368 nurses from 41 nursing homes in the Netherlands were measured with the MAastrIcht Nurses Activity INventory (MAINtAIN)-barriers; perceived promotion of functional activities was measured with the MAINtAIN-behaviors. Descriptive statistics and hierarchical linear regression analyses were performed. Results: Most often experienced barriers were staffing levels, capabilities of residents, and availability of resources. Barriers that were most strongly associated with the promotion of functional activity were communication within the team, (a lack of) referral to responsibilities, and care routines. Discussion: Barriers that are most often experienced among nursing staff are not necessarily the barriers that are most strongly associated with nursing staff–perceived promotion of functional activity.
DOCUMENT
Background: Over the years, a plethora of frailty assessment tools has been developed. These instruments can be basically grouped into two types of conceptualizations – unidimensional, based on the physical–biological dimension – and multidimensional, based on the connections among the physical, psychological, and social domains. At present, studies on the comparison between uni- and multidimensional frailty measures are limited. Objective: The aims of this paper were: 1) to compare the prevalence of frailty obtained using a uni- and a multidimensional measure; 2) to analyze differences in the functional status among individuals captured as frail or robust by the two measures; and 3) to investigate relations between the two frailty measures and disability.
DOCUMENT
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.
MULTIFILE
Background: Community care professionals need to encourage older adults in performing functional activities to maintain independence. However, professionals often perform functional activities on behalf of older adults. To change this, insights into the behavior and barriers of professionals in encouraging activities are required. In the current study, the MAINtAIN questionnaire, which was developed for nursing homes, was adopted. The objective was to create a modified version that is suitable for measuring behavior and barriers of community care professionals in encouraging functional activities of clients in the community care setting. The overall aims were to assess the content validity, construct validity, and internal consistency of the modified version. Methods: Data was collected by qualitative and quantitative methods in two phases. During phase one, the MAINtAIN was assessed on appropriateness and feasibility by community nurses (N = 7), and the adapted questionnaire was assessed on content validity by research experts (N = 9) and community care professionals (N = 18). During phase two, the psychometric properties of the adapted MAINtAIN-C were assessed in community care professionals (N = 80). Construct validity was evaluated by an Exploratory Factor Analysis (EFA), and internal consistency was determined by calculating Cronbach’s alpha coefficients. Results: The formulation, verbs, and wording of the MAINtAIN were adapted; some items were excluded and relevant items were added, resulting in the MAINtAIN-C with two scales, showing good content validity. The Behaviors scale (20 items) measures perceived behavior in encouraging functional activities, expressing good internal consistency (Cronbach’s alpha: .92). The Barriers scale measures barriers in encouraging functional activities related to two dimensions: 1) the clients’ context (7 items), with good internal consistency (.78); and 2) the professional, social, and organizational contexts (21 items), showing good internal consistency (.83). Conclusions: The MAINtAIN-C seems promising to assess the behavior and barriers of community care professionals in encouraging functional activities. It can be used to display a possible difference between perceived and actual behavior, to develop strategies for removing barriers in encouraging activities to foster behavioral change. The results also provide guidance for further research in a larger sample to obtain more insight into the psychometric properties.
DOCUMENT
DOCUMENT
Recalling that a majority of those who need assistive technology do not have access to it, and that this has a significant impact on the education, livelihood, health and well-being of individuals, and on families, communities and societies, Member States adopted a resolution on Improving access to assistive technology during the 71st World Health Assembly in May 2018. Among other mandates, Member States requested the Director-General of the World Health Organization (WHO) to prepare a global report on effective access to assistive technology in the context of an integrated approach, based on the best available scientific evidence and international experience, with the participation of all levels within the organization and in collaboration with all relevant stakeholders. In fulfilling this commitment, aiming to improve access to assistive technology, this global report: • presents the first comprehensive data set of its kind and analysis of current assistive technology access; • draws the attention of governments and civil societies to the need for, and benefits of, assistive technology, including its return on investment; • makes recommendations for concrete actions that will improve access; • supports implementation of the UN Convention on the Rights of Persons with Disabilities; and • contributes towards achieving the Sustainable Development Goals, especially in making universal health coverage (UHC) inclusive – leaving no one behind. The global report explores assistive technology from a variety of perspectives.
DOCUMENT
Background: To date, there is no evidence-based functional therapy programme available for children with both cerebral palsy (CP) and cerebral visual impairment (CVI). This study evaluates an individually targeted functional therapy programme adapted for these children experiencing difficulties with gross motor functioning and functional skills. Methods: Participants: Five children with CP and CVI, mean (SD) age 114 (52) months, participated in this study. Intervention: Participants were assigned to an 18-week functional therapy programme including nine weeks of individual functional therapy aimed at improving gross motor function followed by nine weeks of daily training of functional skills from the parents/caregivers. Analyses: The Related Samples Wilcoxon Signed Rank Test with a significance level of p<.05 was utilised to detect possible significant differences between the pre- and post-test. Results: According to the Goal Attainment Scaling (GAS), each child improved gross motor functioning. All the children also scored significantly higher in the section Functional Skills in the domains self-care and mobility as well as in the section Caregiver Assistance in the domain of self-care. Conclusion: This adapted individually functional therapy programme suggests improved gross motor functioning and functional skills in children with CP and CVI.
DOCUMENT
After being hospitalised, 30–60% of older patients experience a decline in functioning, resulting in a decreased quality of life and autonomy. The objective of this study was to establish a screening instrument for identifying older hospitalised patients at risk for functional decline by comparing the predictive values of three screening instruments: identification of seniors at risk, care complexity prediction instrument and hospital admission risk profile.
DOCUMENT
This dissertation describes a research project about the communication between communication vulnerable people and health care professionals in long-term care settings. Communication vulnerable people experience functional communication difficulties in particular situations, due to medical conditions. They experience difficulties expressing themselves or understanding professionals, and/or professionals experience difficulties understanding these clients. Dialogue conversations between clients and professionals in healthcare, which for example concern health-related goals, activity and participation choices, diagnostics, treatment options, and treatment evaluation, are, however, crucial for successful client-centred care and shared decision making. Dialogue conversations facilitate essential exchanges between clients and healthcare professionals, and both clients and professionals should play a significant role in the conversation. It is unknown how communication vulnerable people and their healthcare professionals experience dialogue conversations and what can be done to support successful communication in these conversations. The aim of this research is to explore how communication vulnerable clients and professionals experience their communication in dialogue conversations in long-term care and how they can best be supported in improving their communication in these conversations.
DOCUMENT
