This study examined patient and appointment factors as predictors of nonattendance in addiction mental health services. Data were collected from the electronic files of 7,641 patients treated for a substance use disorder in outpatient clinics of an addiction mental health organization in the Netherlands. Negative binomial regression analyses revealed that cocaine use, poly substance use, limitations in interpersonal functioning, presence of anxiety disorder and cluster C personality disorder, age, level of education, source of income, and planning consistency were associated with nonattendance.
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This study examined patient and appointment factors as predictors of nonattendance in addiction mental health services. Data were collected from the electronic files of 7,641 patients treated for a substance use disorder in outpatient clinics of an addiction mental health organization in the Netherlands. Negative binomial regression analyses revealed that cocaine use, poly substance use, limitations in interpersonal functioning, presence of anxiety disorder and cluster C personality disorder, age, level of education, source of income, and planning consistency were associated with nonattendance.
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This study examined patient and appointment factors as predictors of nonattendance in addiction mental health services. Data were collected from the electronic files of 7,641 patients treated for a substance use disorder in outpatient clinics of an addiction mental health organization in the Netherlands. Negative binomial regression analyses revealed that cocaine use, poly substance use, limitations in interpersonal functioning, presence of anxiety disorder and cluster C personality disorder, age, level of education, source of income, and planning consistency were associated with nonattendance.
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Physician associates are new to the United Kingdom and set to expand in numbers. Little is known about the patient's perspective. A qualitative study, using semistructured interviews with thematic analysis, was undertaken with 30 volunteer patients of 430 who had consulted PAs in six general practices. Patients' conditions ranged from minor illnesses to those requiring immediate hospital admission. Understanding the PA role varied from certain and correct, to uncertain, to certain and incorrect (in which the patient believed the PA to be a physician). Most, but not all, reported positive experiences and outcomes of their consultation, with some choosing to consult the physician. Those with negative experiences described problems when the limits of the role were reached, delaying prescriptions or requiring additional physician consultations. Trust and confidence were derived from trust in the National Health Service (NHS), the general practice, and the PA. Willingness to consult a PA was contingent on the patient's assessment of the severity or complexity of the problem and the desire for provider continuity. Patients saw PAs as an appropriate general practitioner substitute. Patients' experience could inform delivery redesign.
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Background: In recent years, the effectiveness and cost-effectiveness of digital health services for people with musculoskeletal conditions have increasingly been studied and show potential. Despite the potential of digital health services, their use in primary care is lagging. A thorough implementation is needed, including the development of implementation strategies that potentially improve the use of digital health services in primary care. The first step in designing implementation strategies that fit the local context is to gain insight into determinants that influence implementation for patients and health care professionals. Until now, no systematic overview has existed of barriers and facilitators influencing the implementation of digital health services for people with musculoskeletal conditions in the primary health care setting. Objective: This systematic literature review aims to identify barriers and facilitators to the implementation of digital health services for people with musculoskeletal conditions in the primary health care setting. Methods: PubMed, Embase, and CINAHL were searched for eligible qualitative and mixed methods studies up to March 2024. Methodological quality of the qualitative component of the included studies was assessed with the Mixed Methods Appraisal Tool. A framework synthesis of barriers and facilitators to implementation was conducted using the Consolidated Framework for Implementation Research (CFIR). All identified CFIR constructs were given a reliability rating (high, medium, or low) to assess the consistency of reporting across each construct. Results: Overall, 35 studies were included in the qualitative synthesis. Methodological quality was high in 34 studies and medium in 1 study. Barriers (–) of and facilitators (+) to implementation were identified in all 5 CFIR domains: “digital health characteristics” (ie, commercial neutral [+], privacy and safety [–], specificity [+], and good usability [+]), “outer setting” (ie, acceptance by stakeholders [+], lack of health care guidelines [–], and external financial incentives [–]), “inner setting” (ie, change of treatment routines [+ and –], information incongruence (–), and support from colleagues [+]), “characteristics of the healthcare professionals” (ie, health care professionals’ acceptance [+ and –] and job satisfaction [+ and –]), and the “implementation process” (involvement [+] and justification and delegation [–]). All identified constructs and subconstructs of the CFIR had a high reliability rating. Some identified determinants that influence implementation may be facilitators in certain cases, whereas in others, they may be barriers. Conclusions: Barriers and facilitators were identified across all 5 CFIR domains, suggesting that the implementation process can be complex and requires implementation strategies across all CFIR domains. Stakeholders, including digital health intervention developers, health care professionals, health care organizations, health policy makers, health care funders, and researchers, can consider the identified barriers and facilitators to design tailored implementation strategies after prioritization has been carried out in their local context
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Het aantal banen neemt toe. Jaarlijks ontstaan er volgens CBS (2019) ongeveer 900 duizend vacatures. Deze keer is de verandering op de arbeidsmarkt niet het resultaat van één enkele factor, maar eerder een combinatie van vijf factoren: snelle technologische vooruitgang, diepgaande veranderingen in gezondheid en demografie, een groeiende economie, toenemende globalisering en belangrijke maatschappelijke veranderingen - die samen een groot deel van wat we als vanzelfsprekend beschouwen, fundamenteel transformeren (Gratton, 2011). Digitalisering en automatisering spelen een grote rol bij deze veranderingen. Er zijn optimistische voorspellingen dat nieuwe technologieën de arbeidsmarkt ten goede komen. Technologie verlaagt bijvoorbeeld de werkdruk. We zouden door technologie zelfs naar een kortere werkweek kunnen en nieuwe banen erbij krijgen, zodat niemand ongewild zonder werk komt te zitten (Ford, 2015; Giang, 2015; Mahdawi, 2017; MGI, 2017). Echter, de angst dat automatisering banen over gaat nemen en er een tekort aan werk gaat ontstaan, is ook een veelgehoorde zorg (Alexis, 2017; Ford, 2015; Giang, 2015; MGI, 2017; WRR. 2013).
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Artikel student Facility Management. Beoordeling: 7.
MULTIFILE
Background: Research into termination of long-term psychosocial treatment of mental disorders is scarce. Yearly 25% of people in Dutch mental health services receive long-term treatment. They account for many people, contacts, and costs. Although relevant in different health care systems, (dis)continuation is particularly problematic under universal health care coverage when secondary services lack a fixed (financially determined) endpoint. Substantial, unaccounted, differences in treatment duration exist between services. Understanding of underlying decisional processes may result in improved decision making, efficient allocation of scarce resources, and more personalized treatment.
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Background: Despite high prevalence of mental problems among elderly migrants in The Netherlands, the use of psychosocial care services by this group is low. Scientific evidence points at the crucial role of social support for mental health and the use of psychosocial services. We therefore explored the role of social networks in the access to psychosocial care among elderly migrants in The Netherlands. Methods: A qualitative study was conducted using semi-structured group interviews and individual interviews. The eight group and eleven individual interviews (respectively n = 58 and n = 11) were conducted in The Netherlands with Turkish, Moroccan, Surinamese, and Dutch elderly. The data were analysed through coding and comparing fragments and recognizing patterns. Results: Support of the social network is important to navigate to psychosocial care and is most frequently provided by children. However, the social network of elderly migrants is generally not able to meet the needs of the elderly. This is mostly due to poor mental health literacy of the social network, taboo, and stigma around mental illness and the busy lives of the social network members. Conclusions: Strategies to address help-seeking barriers should consider mental health literacy in elderly migrants as well as their social networks, and counteract taboos and stigma of mental health problems.
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In projects concerning big data, ethical questions need to be answered during the design process. In this paper the Value Sensitive Design method is applied in the context of data-driven health services aimed at disease prevention. It shows how Value Sensitive Design, with the use of a moral dialogue and an ethical matrix, can support the identifcation and operationalization of moral values that are at stake in the design of such services. It also shows that using this method can support meeting the requirements of the General Data Protection Regulation.
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