The aim of this study was to describe patients' experiences of, and preferences for, surgical wound care discharge education and how these experiences predicted their ability to self-manage their surgical wounds. A telephone survey of 270 surgical patients was conducted across two hospitals two weeks after discharge. Patients preferred verbal (n = 255, 94.8%) and written surgical wound education (n = 178, 66.2%) from medical (n = 229, 85.4%) and nursing staff (n = 211, 78.7%) at discharge. The most frequent education content that patients received was information about follow-up appointments (n = 242, 89.6%) and who to contact in the community with wound care concerns (n = 233, 86.6%). Using logistic regression, patients who perceived that they participated in surgical wound care decisions were 6.5 times more likely to state that they were able to manage their wounds at home. Also, patients who agreed that medical and/or nursing staff discussed wound pain management were 3.1 times more likely to report being able to manage their surgical wounds at home. Only 40% (107/270) of patients actively participated in wound-related decision-making during discharge education. These results uncovered patient preferences, which could be used to optimise discharge education practices. Embedding patient participation into clinical workflows may enhance patients' self-management practices once home.
Background: There is a lack of evidence regarding the relationship between family involvement and outcomes in gastrointestinal oncology patients after surgery. To evaluate the effect of a family involvement program for patients undergoing oncologic gastrointestinal surgery on unplanned readmissions within 30 days after surgery. Methods: A multicenter patient-preference cohort study compared 2 groups: patients who participated in the family involvement program versus usual care. The program comprised involvement of family caregivers in care and training of health care professionals in family-centered care. Multivariable regression analyses were used to evaluate the effect of the FIP on the number of unplanned readmissions up to 30 days after surgery. Secondary outcomes included complications sensitive to fundamental care activities, emergency department visits, intensive care unit admissions, hospital length of stay, and the need for professional home care after discharge. Results: Of the 301 patients included, 152 chose the family involvement program, and 149 chose usual care. Postoperative readmissions occurred in 25 (16.4%) patients in the family involvement program group, and 15 (10.1%) in the usual care group (P = .11). A significant reduction of 16.2% was observed in the need for professional home care after discharge in the family involvement program group (P < .01). No significant differences were found between the 2 groups in the other secondary outcomes. Conclusion: The family involvement program did not reduce the number of unplanned readmissions, but it led to a substantial reduction in-home care, which suggests an economic benefit from a societal perspective. Implementation of the family involvement program should, therefore, be considered in clinical practice.
MULTIFILE
Internationalizing curricula. Needs and wishes of alumni and employers with regard to international competencies. Internationalization has become of great importance for universities acrossthe globe. The labour market is becoming international, with internationalopportunities and international competition. Emerging markets such as India, China and Russia are gaining economic power. Global challenges demand world-wide solutions. Production and marketing networks span the globe and various forms of migration have resulted in a large cultural diversity within nations. As a result, societies and labour markets are changing as well. In order to deal with these societal changes adequately and to succeed in today’s labour market, graduates need to be equipped with international competencies. In a survey among 500 chief executives, ICM Research (on behalf of Think Global and The British Council, 2011) showed that employers strongly value staff members who are able to work in an international and multicultural environment. Similar results were found in Diamond et al. (2011), in which ‘multicultural teamwork’ was considered most important. The Hague University of Applied Sciences seeks to prepare its students adequately for the world of tomorrow. The University’s development plans (e.g. HogeschoolOntwikkelingsPlan, HOP 7, 2009-2013 and HOP 8, 2014-2017) indicate that its vision is to train students to be globally-minded professionals with an international and multicultural perspective, who are world-citizens, interested in global issues and able to deal with diversity in a constructive manner. They are to be professionals, who possess the competencies to function well in an international and intercultural environment. Internationalization is therefore high on the agenda of The Hague University of Applied Sciences (THUAS) which is illustrated by the fact that, as of 2014, new students in all academies have to fill 12.5% (30 ECTS) of their four-year Bachelor program with international activities. These activities can range from an internship or semester abroad (student mobility) to participating in full programs of study or minors in which English is the medium of instruction, or an internationally themed minor (Internationalization at Home, IaH). And this is only the beginning. Internationalization is a means, not an end. All THUAS courses are looking into ways in which they can internationalize their curriculum. And in doing so, they need to be innovative (Leask, 2009) and keep in mind the specific needs and wishes of alumni and their employers with regard to international competences. The THUAS research group International Cooperation supports these internationalization policy objectives by investigating various aspects, such as: • The acquisition and development of international competencies among students. • The extent to which lecturers possess international competencies and what their needs and wishes are for further development. • The international competencies THUAS graduates have acquired as part of their degree and how THUAS has stimulated this development. • The international competencies that employers and alumni consider important. Although international competencies and employability have received growing attention in internationalization research, existing studies have mainly focused on: • The effects of study abroad on the development of international competence (cf. Hoven & Walenkamp, 2013). • The effects of an experience abroad (study, internship, voluntary work) on employability. • A more general analysis of the skills employers look for in prospective employees.
