ObjectiveHospital-to-home (H2H) transitions challenge families of children with medical complexity (CMC) and healthcare professionals (HCP). This study aimed to gain deeper insights into the H2H transition process and to work towards eHealth interventions for its improvement, by applying an iterative methodology involving both CMC families and HCP as end-users.MethodsFor 20-weeks, the Dutch Transitional Care Unit consortium collaborated with the Amsterdam University of Applied Sciences, HCP, and CMC families. The agile SCREAM approach was used, merging Design Thinking methods into five iterative sprints to stimulate creativity, ideation, and design. Continuous communication allowed rapid adaptation to new information and the refinement of solutions for subsequent sprints.ResultsThis iterative process revealed three domains of care – care coordination, social wellbeing, and emotional support – that were important to all stakeholders. These domains informed the development of our final prototype, ‘Our Care Team’, an application tailored to meet the H2H transition needs for CMC families and HCP.ConclusionComplex processes like the H2H transition for CMC families require adaptive interventions that empower all stakeholders in their respective roles, to promote transitional care that is anticipatory, rather than reactive.InnovationA collaborative methodology is needed, that optimizes existing resources and knowledge, fosters innovation through collaboration while using creative digital design principles. This way, we might be able to design eHealth solutions with end-users, not just for them.
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Stress is increasingly being recognized as one of the main factors that is negatively affecting our health, and therefore there is a need to regulate daily stress and prevent long-term stress. This need seems particularly important for adults with mild intellectual disabilities (MID) who have been shown to have more difficulties coping with stress than adults without intellectual disabilities. Hence, the development of music therapy interventions for stress reduction, particularly within populations where needs may be greater, is becoming increasingly important. In order to gain more insight into the practice-based knowledge on how music therapists lower stress levels of their patients with MID during music therapy sessions, we conducted focus group interviews with music therapists working with adults with MID (N = 13) from different countries and clinical institutions in Europe. Results provide an overview of the most-used interventions for stress reduction within and outside of music. Data-analysis resulted in the further specification of therapeutic goals, intervention techniques, the use of musical instruments, and related therapeutic change factors. The main findings indicate that music therapists used little to no receptive (e.g., music listening) interventions for stress reduction, but preferred to use active interventions, which were mainly based on musical improvisation. Results show that three therapy goals for stress relief could be distinguished. The goal of “synchronizing” can be seen as a sub goal because it often precedes working on the other two goals of “tension release” or “direct relaxation,” which can also be seen as two ways of reaching stress reduction in adults with MID through music therapy interventions. Furthermore, the tempo and the dynamics of the music are considered as the most important musical components to reduce stress in adults with MID. Practical implications for stress-reducing music therapy interventions for adults with MID are discussed as well as recommendations for future research.
Social needs are important basic human needs; when not satisfied, loneliness and social isolation can occur and subsequently sickness or even premature death. For older people social needs can be more difficult to satisfy because of the loss of resources such as health and mobility. Interventions for older people to satisfy social needs are often not evaluated and when evaluated are not proven successful. Technological interventions can be successful, but the relationship between technology and social wellbeing is complex and more research in this area is needed. The aim of this research is to uncover design opportunities for technological interventions to fulfil social needs of older people. Context-mapping sessions are a way to gain more insight into the social needs of older people and to involve them in the design of interventions to fulfil social needs. Participants of the context-mapping sessions were older people and social workers working with older people. Four sessions with a total of 20 participants were held to generate ideas for interventions to satisfy social needs. The results are transcripts from the discussion parts of the context-mapping sessions and collages the participants created. The transcripts were independently analysed and inductive codes were attached to quotations in the transcripts that are relevant to the research question and subsequently thematic analysis took place. Collages made by the participants were independently analysed by the researchers and after discussion consensus was reached about important themes. The following three main themes emerged: ‘connectedness’, ‘independence’ and ‘meaningfulness’. Technology was not identified as a separate theme, but was addressed in relation to the above mentioned themes. Staying active in a meaningful way, for example by engaging in volunteer work, may fulfil the three needs of being connected, independent and meaningful. In addition, interventions can also focus on the need to be and remain independent and to deal with becoming more dependent. The older people in our study have an ambivalent attitude towards technology, which needs to be taken into account when designing an intervention. We conclude this paper by making recommendations for possible technological interventions to fulfil social needs.
Het probleem dat deze projectaanvraag adresseert is de hoge werkdruk van zorgprofessionals in de dementiezorg. Door een stijging in het aantal ouderen met dementie, stijgt de zorgvraag, terwijl het tekort aan zorgprofessionals groeit. Door de inzet van slimme technologische innovaties zoals een Intelligente Zorgomgeving kan deze werkdruk sterk verminderd worden. Een Intelligente Zorgomgeving maakt gebruik van sensortechnieken en gebruikt Artificiële Intelligentie (AI) om gepersonaliseerde zorg te leveren door de zorgbehoefte in kaart te brengen en daarop te reageren. De Intelligente Zorgomgeving werkt daarbij samen met de zorgprofessional. Deze oplossingsrichting wordt in dit project verder uitgewerkt samen met vier zorgpartijen en drie innovatieve MKB. Aan de hand van de casus “Ondersteuning bij eten en drinken” worden Just-in-time adaptive interventions (JITAI) ontwikkeld zodat de zorgprofessional de zorgprofessional ondersteund wordt in het uitvoeren van bepaalde zorgtaken. Een voorbeeld van een interventie is het op het juiste moment geven van op de persoon aangepaste zintuigelijke prikkels (geluiden, lichten en projecties) die senioren stimuleren om te eten. Door dergelijke interventies wordt de druk op de zorgprofessional verminderd en neemt de kwaliteit van de zorg toe. Niet alleen de integratie van de AI-modules is van belang maar ook hoe de AI ‘getoond’ wordt aan de zorgprofessional. Daarom wordt er in dit project ook extra aandacht besteed aan de interactie tussen zorgprofessional en de Intelligente Zorgomgeving waardoor het gebruiksgemak wordt verhoogd en zowel cliënt als zorgprofessional een hogere mate van autonomie kunnen ervaren. Door het prototype van de Intelligente Zorgomgeving verder te ontwikkelen in zorginstellingen in samenwerking met verschillende zorgprofessionals en aandacht te besteden aan het ontwikkelen van AI en Interactie met het systeem kunnen de wensen en behoeften van de zorgprofessionals worden geïntegreerd in de Intelligente Zorgomgeving. Dit gebeurt in drie iteraties waarbij de drie opeenvolgende beschikbare living labs in toenemende mate complex en realistisch zijn.
