Purpose: This study aimed to develop and pretest a systematic conversation approach for nurses to tailor aftercare to oncology patient's goals, unmet needs and wishes. Methods: We used an iterative developmental process for complex interventions: 1. Identifying problems 2. Identifying overall objectives 3. Designing the intervention 4. Pretesting and adapting the intervention. Results: The main results of the problem identification were: non-systematic and incomplete screening of potential issues, caveats in providing information, and shared decision-making. The overall objective formulated was: To develop a model for aftercare conversations based on shared goal-setting and decision-making. The conversation approach consists of four phases: 1. Preparation of the consultation including a questionnaire, 2. Shared goal-setting by means of a tool visualizing domains of life, and 3. Shared care planning by means of an overview of possible choices in aftercare, a database with health care professionals and a cancer survivorship care plan. 4. Evaluation. The results of the pretest revealed that the conversation approach needs to be flexible and tailored to the patient and practice setting, and embedded in the care processes. The conversation approach was perceived as enhancing patient-centeredness and leading to more in-depth consultations. Conclusion: The conversation approach was developed in co-creation with stakeholders. The results of the pretest revealed important implications and suggestions for implementation in routine care. The aftercare conversation approach can be used by nurses to provide tailored patient-centered evidence-based aftercare. Tailored aftercare should support oncology patient's goals, unmet needs and wishes. Further tailoring is needed.
Europe’s aging population is leading to a growing number of people affected by chronic disease, which will continue over the coming decades. Healthcare systems are under pressure to deliver appropriate care, partly due to the burden imposed on their limited financial and human resources by the growing number of people with (multiple) chronic diseases. Therefore, there is a strong call for patient self-management to meet these patients’ healthcare needs. While many patients experience medication self-management as difficult, it poses additional challenges for people with limited health literacy. This thesis aims to explore the needs of patients with a chronic disease and limited health literacy regarding medication self-management and how support for medication self-management can be tailored to those needs.
Background: A large number of people participate in individual or unorganized sports on a recreational level. Furthermore, many participants drop out because of injury or lowered motivation. Potentially, physical activity–related apps could motivate people during sport participation and help them to follow and maintain a healthy active lifestyle. It remains unclear what the quality of running, cycling, and walking apps is and how it can be assessed. Quality of these apps was defined as having a positive influence on participation in recreational sports. This information will show which features need to be assessed when rating physical activity–related app quality. Objective: The aim of this study was to identify expert perception on which features are important for the effectiveness of physical activity–related apps for participation in individual, recreational sports. Methods: Data were gathered via an expert panel approach using the nominal group technique. Two expert panels were organized to identify and rank app features relevant for sport participation. Experts were researchers or professionals in the field of industrial design and information technology (technology expert panel) and in the field of behavior change, health, and human movement sciences who had affinity with physical activity–related apps (health science expert panel). Of the 24 experts who were approached, 11 (46%) agreed to participate. Each panel session consisted of three consultation rounds. The 10 most important features per expert were collected. We calculated the frequency of the top 10 features and the mean importance score per feature (0-100). The sessions were taped and transcribed verbatim; a thematic analysis was conducted on the qualitative data. Results: In the technology expert panel, applied feedback and feedforward (91.3) and fun (91.3) were found most important (scale 0-100). Together with flexibility and look and feel, these features were mentioned most often (all n=4 [number of experts]; importance scores=41.3 and 43.8, respectively). The experts in the health science expert panels a and b found instructional feedback (95.0), motivating or challenging (95.0), peer rating and use (92.0), motivating feedback (91.3), and monitoring or statistics (91.0) most important. Most often ranked features were monitoring or statistics, motivating feedback, works good technically, tailoring starting point, fun, usability anticipating or context awareness, and privacy (all n=3-4 [number of experts]; importance scores=16.7-95.0). The qualitative analysis resulted in four overarching themes: (1) combination behavior change, technical, and design features needed; (2) extended feedback and tailoring is advised; (3) theoretical or evidence base as standard; and (4) entry requirements related to app use. Conclusions: The results show that a variety of features, including design, technical, and behavior change, are considered important for the effectiveness of physical activity–related apps by experts from different fields of expertise. These insights may assist in the development of an improved app rating scale.
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Sustainable energy production relies on smart design of functional nanomaterials with controllable sizes and structures. Core-shell nanoparticles are highly functional materials with properties arising from the core or shell materials or a combination of both. Changing the electronic properties of the shell by tailored design or induced by the underlying core lead to enhanced catalytic performances, especially in electrocatalysis. Tailoring the structure and functions of core and shell materials simultaneously often involves complex chemical methods. In this KIEM GoChem project, University of Amsterdam will work together with VSParticle, Spark904 and Inholland University of Applied Sciences to develop a novel and environmentally friendly method for the gas-phase synthesis of core-shell nanoparticles. A physical process will be used to control the growth and the mean size of the core whilst the structure and thickness of the shell will be tuned via selective adsorption and thermal processes. Core-shell nanoparticles produced by the proposed method can be directly incorporated into the next process step, e.g. at electrode surface or in (conductive) composites.