Background: Limited information is available on the experiences of patients during rehabilitation after anterior cruciate ligament reconstruction (ACLR). Aim: The current study aimed to identify factors that differentiated positive and negative patient experiences during rehabilitation after ACLR. Method and Design: A survey-based study with an online platform was used to identify factors that differentiated positive and negative patient experiences during rehabilitation after ACLR. Seventy-two patients (age 27.8 [8.8] y) after ACLR participated. Data were analyzed and themes were identified by comparing categories and subcategories on similarity. Main Findings: Positive patient experiences were room for own input, supervision, attention, knowledge, honesty, and professionalism of the physiotherapist. Additionally, a varied and structured rehabilitation program, adequate facilities, and contact with other patients were identified as positive patient experiences. Negative experiences were a lack of attention, lack of professionalism of the physiotherapists, a lack of sport-specific field training, a lack of goal setting, a lack of adequate facilities, and health insurance costs. Conclusions: The current study identified factors that differentiated positive and negative patient experiences during rehabilitation after ACLR. These findings can help physiotherapists in understanding the patient experiences during rehabilitation after ACLR.
Rationale, aims and objective: Primary Care Plus (PC+) focuses on the substitution of hospital-based medical care to the primary care setting without moving hospital facilities. The aim of this study was to examine whether population health and experience of care in PC+ could be maintained. Therefore, health-related quality of life (HRQoL) and experienced quality of care from a patient perspective were compared between patients referred to PC+ and to hospital-based outpatient care (HBOC). Methods: This cohort study included patients from a Dutch region, visiting PC+ or HBOC between December 2014 and April 2018. With patient questionnaires (T0, T1 and T2), the HRQoL and experience of care were measured. One-to-two nearest neighbour calliper propensity score matching (PSM) was used to control for potential selection bias. Outcomes were compared using marginal linear models and Pearson chi-square tests. Results: One thousand one hundred thirteen PC+ patients were matched to 606 HBOC patients with well-balanced baseline characteristics (SMDs <0.1). Regarding HRQoL outcomes, no significant interaction terms between time and group were found (P > .05), indicating no difference in HRQoL development between the groups over time. Regarding experienced quality of care, no differences were found between PC+ and HBOC patients. Only travel time was significantly shorter in the HBOC group (P ≤ .001). Conclusion: Results show equal effects on HRQoL outcomes over time between the groups. Regarding experienced quality of care, only differences in travel time were found. Taken as a whole, population health and quality of care were maintained with PC+ and future research should focus more on cost-related outcomes.
Background: In implementation science, vast gaps exist between theoretical and practical knowledge. These gaps prevail in the process of getting from problem analysis to selecting implementation strategies while engaging stakeholders including care users. Objective: To describe a process of how to get from problem analysis to strategy selection, how to engage stakeholders, and to provide insights into stakeholders’ experiences. Design: A qualitative descriptive design. Setting and participants: The setting was a care organization providing long-term care to people with acquired brain injuries who are communication vulnerable. Fourteen stakeholders (care users, professionals and researchers) participated. Data were collected by a document review, five interviews and one focus group. Inductive content analysis and deductive framework analysis were applied. Intervention: Stakeholder engagement. Main outcome measures: A three-step process model and stakeholders experiences. Results and conclusion: We formulated a three-step process: (a) reaching consensus and prioritizing barriers; (b) categorizing the prioritized barriers and idealization; and (c) composing strategies. Two subthemes continuously played a role in how stakeholders were engaged during the process: communication supportive strategies and continuous contact. The experiences of stakeholder participation resulted in the following themes: stakeholders and their roles, use of co-creation methods and communication supportive strategies, building relationships, stimulus of stakeholders to engage, sharing power, empowerment of stakeholders, feeling a shared responsibility and learning from one another. We conclude that the inclusion of communicationvulnerable care users is possible if meetings are prepared, communication-friendly presentations and reports are used, and relationship building is prioritized.
In this project, we explore how healthcare providers and the creative industry can collaborate to develop effective digital mental health interventions, particularly for survivors of sexual assault. Sexual assault victims face significant barriers to seeking professional help, including shame, self-blame, and fear of judgment. With over 100,000 cases reported annually in the Netherlands the need for accessible, stigma-free support is urgent. Digital interventions, such as chatbots, offer a promising solution by providing a safe, confidential, and cost-effective space for victims to share their experiences before seeking professional care. However, existing commercial AI chatbots remain unsuitable for complex mental health support. While widely used for general health inquiries and basic therapy, they lack the human qualities essential for empathetic conversations. Additionally, training AI for this sensitive context is challenging due to limited caregiver-patient conversation data. A key concern raised by professionals worldwide is the risk of AI-driven chatbots being misused as therapy substitutes. Without proper safeguards, they may offer inappropriate responses, potentially harming users. This highlights the urgent need for strict design guidelines, robust safety measures, and comprehensive oversight in AI-based mental health solutions. To address these challenges, this project brings together experts from healthcare and design fields—especially conversation designers—to explore the power of design in developing a trustworthy, user-centered chatbot experience tailored to survivors' needs. Through an iterative process of research, co-creation, prototyping, and evaluation, we aim to integrate safe and effective digital support into mental healthcare. Our overarching goal is to bridge the gap between digital healthcare and the creative sector, fostering long-term collaboration. By combining clinical expertise with design innovation, we seek to develop personalized tools that ethically and effectively support individuals with mental health problems.
communicative participation, language disordersOBJECTIVE(S)/RESEARCH QUESTION(S) Speech and language therapists (SLTs) are the primary care professionals to treat language and communication disorders. Their treatment is informed by a variety of outcome measures. At present, diagnosis, monitoring of progress and evaluation are often based on performance-based and clinician-reported outcomes such as results of standardized speech, language, voice, or communication tests. These tests typically aim to capture how well the person can produce or understand language in a controlled situation, and therefore only provide limited insight in the person’s challenges in life. Performance measures do not incorporate the unobservable feelings such as a patient's effort, social embarrassment, difficulty, or confidence in communication. Nor do they address language and communication difficulties experienced by the person themselves, the impact on daily life or allow patients to set goals related to their own needs and wishes. The aim of our study is give our patients a voice and empower SLTs to incorporate their patient's perspective in planning therapy. We will Aangemaakt door ProjectNet / Generated by ProjectNet: 08-12-2020 12:072Subsidieaanvraag_digitaal / Grant Application_digitaalDossier nummer / Dossier number: 80-86900-98-041DEFINITIEFdevelop a valid and reliable patient-reported outcome measure that provides information on communicative participation of people with communication disorders and integrate this item bank in patient specific goal setting in speech and language therapy. Both the item bank and the goal setting method will be adapted in cocreation with patients to enable access for people with communication difficulties.STUDY DESIGN Mixed methods research design following the MRC guidance for process evaluation of complex interventions, using PROMIS methodology including psychometric evaluation and an iterative user-centered design with qualitative co-creation methods to develop accessible items and the goal setting method.RESEARCH POPULATION Children, adolescents and adults with speech, language, hearing, and voice disorders.OUTCOME MEASURES An online patient-reported outcome measure on communicative participation, the Communicative Participation Item Bank (CPIB), CPIB items that are accessible for people with language understanding difficulties, a communicative-participation person-specific goal setting method developed with speech and language therapists and patients and tested on usability and feasibility in clinical practice, and a course for SLTs explaining the use of the goal-setting method in their clinical reasoning process.RELEVANCE This study answers one of the prioritized questions in the call for SLTs to systematically and reliably incorporate the clients’ perspective in their daily practice to improve the quality of SLT services. At present patient reported outcomes play only a small role in speech and language therapy because 1) measures (PROMS) are often invalid, not implemented and unsuitable for clinical practice and 2) there is a knowledge gap in how to capture and interpret outcomes from persons with language disorders.
In dit project werkt het lectoraat ‘Bewegen, gezondheid en welzijn’ samen met de Hogeschool Arnhem Nijmegen, Hogeschool Zuyd, de Vrije Universiteit, de Universiteit van Maastricht, het UMC Groningen, drie GGZ instellingen (Universitair Centrum Psychiatrie Groningen (UCP), GGZ Friesland en GGZ Drenthe), de Nederlandse Vereniging voor Psychomotorische Therapie en het Landelijk Platform Geestelijke Gezondheidzorg (LPGGZ, nu ook MIND). De projectdoelstelling is: Het verwerven van nieuwe kennis over de ontwikkeling en implementatie van specifieke uitkomstmaten waarmee de impact van psychomotorische interventies binnen de GGZ gemonitord en geëvalueerd kan worden en de samenwerking met de betrokken patiënt wordt versterkt. Aanleiding voor dit project zijn praktijkvragen van psychomotorisch therapeuten werkzaam in de GGZ. Zij geven aan behoefte te hebben aan nieuwe kennis en meetinstrumenten waarmee ze: 1. het behandelresultaat en de toenemende vraag naar evidentie van psychomotorische therapie (PMT) )vast kunnen stellen; 2. het beloop van de behandeling kunnen monitoren en bespreekbaar kunnen maken met de betrokken patiënt. Op basis van de beschikbare literatuur over behandelevaluaties werd de volgende onderzoeksvraag geformuleerd: ‘Hoe kunnen Patient Reported Outcome Measures (PROMs) voor psychomotorische therapie ontwikkeld en ingezet worden om het specifieke resultaat van psychomotorische therapie bij volwassen patiënten in de GGZ gestandaardiseerd te evalueren en wat kan de bijdrage zijn van dagboekmetingen via Experience Sampling Methods (ESM)?’. Het project richt zich op: 1. Selectie, onderzoek en onderbouwing van PMT specifieke PROMS. 2. Onderzoeken van de haalbaarheid van de inzet van ESM als evaluatiemethode binnen de PMT. 3. De ontwikkeling van een digitale portal. Beoogde resultaten zijn: • Databank van Nederlandstalige meetinstrumenten die als PROMs kunnen dienen ter evaluatie van pychomotorische interventies en die zijn opgenomen in een portal dat beschikbaar komt voor de beroepsgroep. • Handboek over het inzetten van ESM binnen PMT. • Cursussen over het gebruik van de PROMs en het gebruik van ESM.
