Zoekresultaten

What moves patients to participate in prehabilitation before major surgery? A mixed methods systematic review

Background Prehabilitation offers patients the opportunity to actively participate in their perioperative care by preparing themselves for their upcoming surgery. Experiencing barriers may lead to non-participation, which can result in a reduced functional capacity, delayed post-operative recovery and higher healthcare costs. Insight in the barriers and facilitators to participation in prehabilitation can inform further development and implementation of prehabilitation. The aim of this review was to identify patient-experienced barriers and facilitators for participation in prehabilitation. Methods For this mixed methods systematic review, articles were searched in PubMed, EMBASE and CINAHL. Articles were eligible for inclusion if they contained data on patient-reported barriers and facilitators to participation in prehabilitation in adults undergoing major surgery. Following database search, and title and abstract screening, full text articles were screened for eligibility and quality was assessed using the Mixed Method Appraisal Tool. Relevant data from the included studies were extracted, coded and categorized into themes, using an inductive approach. Based on these themes, the Capability, Opportunity, Motivation, Behaviour (COM-B) model was chosen to classify the identified themes. Results Three quantitative, 14 qualitative and 6 mixed methods studies, published between 2007 and 2022, were included in this review. A multitude of factors were identified across the different COM-B components. Barriers included lack of knowledge of the benefits of prehabilitation and not prioritizing prehabilitation over other commitments (psychological capability), physical symptoms and comorbidities (physical capability), lack of time and limited financial capacity (physical opportunity), lack of social support (social opportunity), anxiety and stress (automatic motivation) and previous experiences and feeling too fit for prehabilitation (reflective motivation). Facilitators included knowledge of the benefits of prehabilitation (psychological capability), having access to resources (physical opportunity), social support and encouragement by a health care professional (social support), feeling a sense of control (automatic motivation) and beliefs in own abilities (reflective motivation). Conclusions A large number of barriers and facilitators, influencing participation in prehabilitation, were found across all six COM-B components. To reach all patients and to tailor prehabilitation to the patient’s needs and preferences, it is important to take into account patients’ capability, opportunity and motivation.

Factors influencing intergenerational learning

The workforce in the EU is ageing, and this requires investment in older workers so that the organisations in which they work remain competitive and viable. One such investment takes the form of organising and facilitating intergenerational learning: learning between and among generations that can lead to lifelong learning, innovation and organisational development. However, successfully implementing intergenerational learning is complex and depends on various factors at different levels within the organisation. This multidisciplinary literature review encompasses work from the fields of cognitive psychology, occupational health, educational science, human resource development and organisational science and results in a framework that organisations can use to understand how they can create the conditions needed to ensure that the potential of their ageing workforce is tapped effectively and efficiently. Although not a comprehensive review, this chapter serves as a basis for further empirical research and gives practitioners an insight into solving a growing problem.

Meta-Model of Interprofessional Development.

Het Meta-Model of Interprofessional Development wordt beschreven. Deze bestaat uit diverse factoren die prioriteit zouden moeten krijgen om verschillende beroepsgroepen complementair te laten samenwerken om zo tot optimale en gezamenlijke uitkomsten te kunnen komen. Deze factoren vormen tezamen een systemische samenhang omdat zij een wisselwerking op elkaar hebben. Diverse wetenschappelijk toetsbare assumpties worden beschreven voor elk van deze factoren (fasen) in relatie tot interprofessionele ontwikkeling en in relatie tot hun onderlinge samenhang.

No Gizmos

Optimising Financial Advice to SMEs: Developing a Roadmap for Mixed Method SME Financing

An English summary of the report “Optimalisering financieel advies aan mkb-ondernemers: praktijkverkenning stappenplan gestapeld financieren” [in Dutch]

A transition approach towards a sustainable and healthy food system: the case of the South-Holland Food Family

The transition towards a sustainable and healthy food system is one of the major sustainability challenges of today, next to the energy transition and the transition from a linear to circular economy. This paper provides a timely and evidence-based contribution to better understand the complex processes of institutional change and transformative social-ecological innovation that takes place in the food transition, through a case study of an open innovation and food transition network in The Netherlands, the South-Holland Food Family (Zuid-Hollandse Voedselfamilie). This network is supported by the provincial government and many partners, with the ambition to realize more sustainable agricultural and food chains, offering healthy, sustainable and affordable food for everyone in the Province of South-Holland in five to ten years from now. This ambition cannot be achieved through optimising the current food system. A transition is needed – a fundamental change of the food system’s structure, culture and practice. The Province has adopted a transition approach in its 2016 Innovation Agenda for Sustainable Agriculture. This paper provides an institutional analysis of how the transition approach has been established and developed in practice. Our main research question is what interventions and actions have shaped the transition approach and how does the dynamic interplay between actors and institutional structures influence institutional change, by analysing a series of closely related action situations and their context, looking at 'structure' and 'agency', and at the output-outcomes-impact of these action situations. For this purpose, we use the Transformative Social-Ecological Innovation (TSEI)-framework to study the dynamic interplay between actors and institutional structures influencing institutional change. The example of TSEI-framework application in this paper shows when and how local agents change the institutional context itself, which provides relevant insights on institutional work and the mutually constitutive nature of structure and agency. Above institutional analysis also shows the pivotal role of a number of actors, such as network facilitators and provincial minister, and their capability and skills to combine formal and informal institutional environments and logics and mobilize resources, thereby legitimizing and supporting the change effort. The results are indicative of the importance of institutional structures as both facilitating (i.e., the province’s policies) and limiting (e.g. land ownership) transition dynamics.