Purpose: The increasing number of cancer survivors has heightened demands on hospital-based follow-up care resources. To address this, involving general practitioners (GPs) in oncological follow-up is proposed. This study explores secondary care providers’ views on integrating GPs into follow-up care for curatively treated breast and colorectal cancer survivors. Methods: A qualitative exploratory study was conducted using semi-structured interviews with Dutch medical specialists and nurse practitioners. Interviews were recorded, transcribed verbatim, and analyzed using thematic analysis by two independent researchers. Results: Fifteen medical specialists and nine nurse practitioners participated. They identified barriers such as re-referral delays, inexperience to perform structured follow-up, and worries about the lack of oncological knowledge among GPs. Benefits included the GPs’ accessibility and their contextual knowledge. For future organization, they emphasized the need for hospital logistics changes, formal GP training, sufficient case-load, proper staffing, remuneration, and time allocation. They suggested that formal GP involvement should initially be implemented for frail older patients and for prevalent cancer types. Conclusions: The interviewed Dutch secondary care providers generally supported formal involvement of primary care in cancer follow-up. A well-organized shared-care model with defined roles and clear coordination, supported by individual patients, was considered essential. This approach requires logistics adaptation, resources, and training for GPs. Implications for cancer survivors: Integrating oncological follow-up into routine primary care through a shared-care model may lead to personalized, effective, and efficient care for survivors because of their long-term relationships with GPs.
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Background: A highly promoted opportunity for optimizing healthcare services is to expand the role of nonphysician care providers by care reallocation. Reallocating care from physicians to non-physicians can play an important role in solving systemic healthcare problems such as care delays, hospital overcrowding, long waiting lists, high work pressure and expanding healthcare costs. Dermatological healthcare services, such as the acne care provision, are well suited for exploring the opportunities for care reallocation as many different types of care professionals are involved in the care process. In the Netherlands, acne care is mainly delivered by general practitioners and dermatologists. The Dutch healthcare system also recognizes non-physician care providers, among which dermal therapists and beauticians are the most common professions. However, the role and added value of non-physicians is still unclear. The present study aimed to explore the possibilities for reallocating care to nonphysicians and identify drivers for and barriers to reallocation. Methods: A mixed-method design was used collecting quantitative and qualitative data from representatives of the main 4 Dutch professions providing acne care: dermatologists, GP’s, Dermal therapists and beauticians. Results: A total of 560 questionnaires were completed and 24 semi-structured interviews were conducted. A broad spectrum of non-physician tasks and responsibilities were delineated. Interviewed physicians considered acne as a low-complexity skin condition which made them willing to explore the possibilities for reallocating. A majority of all interviewees saw a key role for non-physicians in counselling and supporting patients during treatment, which they considered an important role for increasing patients’ adherence to proposed treatment regimes, contributing to successful clinical outcome. Also, the amount of time non-physicians spend on patients was experienced as driver for reallocation. Legislation and regulations, uncertainties about the extent of scientific evidence and proper protocols use within the non-physician clinical practice were experienced as barriers influencing the possibilities for reallocation. Conclusions: Delineated roles and drivers demonstrate there is room and potential for reallocation between physicians and non-physicians within acne healthcare, when barriers are adequately addressed.
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University teacher teams can work toward educational change through the process of team learning behavior, which involves sharing and discussing practices to create new knowledge. However, teachers do not routinely engage in learning behavior when working in such teams and it is unclear how leadership support can overcome this problem. Therefore, this study examines when team leadership behavior supports teacher teams in engaging in learning behavior. We studied 52 university teacher teams (281 respondents) involved in educational change, resulting in two key findings. First, analyses of multiple leadership types showed that team learning behavior was best supported by a shared transformational leadership style that challenges the status quo and stimulates team members’ intellect. Mutual transformational encouragement supported team learning more than the vertical leadership source or empowering and initiating structure styles of leadership. Second, moderator analyses revealed that task complexity influenced the relationship between vertical empowering team leadership behavior and team learning behavior. Specifically, this finding suggests that formal team leaders who empower teamwork only affected team learning behavior when their teams perceived that their task was not complex. These findings indicate how team learning behavior can be supported in university teacher teams responsible for working toward educational change. Moreover, these findings are unique because they originate from relating multiple team leadership types to team learning behavior, examining the influence of task complexity, and studying this in an educational setting.
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University teacher teams can work toward educational change through the process of team learning behavior, which involves sharing and discussing practices to create new knowledge. However, teachers do not routinely engage in learning behavior when working in such teams and it is unclear how leadership support can overcome this problem. Therefore, this study examines when team leadership behavior supports teacher teams in engaging in learning behavior. We studied 52 university teacher teams (281 respondents) involved in educational change, resulting in two key findings. First, analyses of multiple leadership types showed that team learning behavior was best supported by a shared transformational leadership style that challenges the status quo and stimulates team members’ intellect. Mutual transformational encouragement supported team learning more than the vertical leadership source or empowering and initiating structure styles of leadership. Second, moderator analyses revealed that task complexity influenced the relationship between vertical empowering team leadership behavior and team learning behavior. Specifically, this finding suggests that formal team leaders who empower teamwork only affected team learning behavior when their teams perceived that their task was not complex. These findings indicate how team learning behavior can be supported in university teacher teams responsible for working toward educational change. Moreover, these findings are unique because they originate from relating multiple team leadership types to team learning behavior, examining the influence of task complexity, and studying this in an educational setting. https://www.scienceguide.nl/2021/06/leren-van-docentteams-vraagt-om-gezamenlijk-leiderschap/
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Demand Driven Care plays a key role in the modernization of the Dutch health care system. This modernization is needed because a) clients needs for care increases quantitatively as well as in diversity, b) the financial means for collective services are inadequate, c) the accessibility of health care will depend on clients own responsibility, and d) shortage of professional care givers is foreseen. In the Netherlands, the need for professional care givers increases with an average of 2% every year. Demand Driven Care is an instrument for liberalization of public activities. The Faculty Chair Demand Driven Care focuses on those activities that will contribute to sufficient care supply. Within the program of the chair, activities are executed under the theme of Integrated Care, Substitution, Patient Centred Care, and Home Care Technology with an emphasis on gerontechnology. The Faculty Chair wants to contribute to a better integration and coherence in care. So that clients live and function independently as long as possible and are able to enhance their self management. In addition, health care professionals should be aware of demand driven processes and should have a demand driven attitude towards clients.
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Citizens regularly search the Web to make informed decisions on daily life questions, like online purchases, but how they reason with the results is unknown. This reasoning involves engaging with data in ways that require statistical literacy, which is crucial for navigating contemporary data. However, many adults struggle to critically evaluate and interpret such data and make data-informed decisions. Existing literature provides limited insight into how citizens engage with web-sourced information. We investigated: How do adults reason statistically with web-search results to answer daily life questions? In this case study, we observed and interviewed three vocationally educated adults searching for products or mortgages. Unlike data producers, consumers handle pre-existing, often ambiguous data with unclear populations and no single dataset. Participants encountered unstructured (web links) and structured data (prices). We analysed their reasoning and the process of preparing data, which is part of data-ing. Key data-ing actions included judging relevance and trustworthiness of the data and using proxy variables when relevant data were missing (e.g., price for product quality). Participants’ statistical reasoning was mainly informal. For example, they reasoned about association but did not calculate a measure of it, nor assess underlying distributions. This study theoretically contributes to understanding data-ing and why contemporary data may necessitate updating the investigative cycle. As current education focuses mainly on producers’ tasks, we advocate including consumers’ tasks by using authentic contexts (e.g., music, environment, deferred payment) to promote data exploration, informal statistical reasoning, and critical web-search skills—including selecting and filtering information, identifying bias, and evaluating sources.
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Research into automatic text simplification aims to promote access to information for all members of society. To facilitate generalizability, simplification research often abstracts away from specific use cases, and targets a prototypical reader and an underspecified content creator. In this paper, we consider a real-world use case – simplification technology for use in Dutch municipalities – and identify the needs of the content creators and the target audiences in this scenario. The stakeholders envision a system that (a) assists the human writer without taking over the task; (b) provides diverse outputs, tailored for specific target audiences; and (c) explains the suggestions that it outputs. These requirements call for technology that is characterized by modularity, explainability, and variability. We argue that these are important research directions that require further exploration
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BACKGROUND: Today's nursing school applicants are considered “digital natives.” This study investigated students' views of new health care technologies. METHOD: In a cross-sectional survey among first-year nursing students, 23 common nursing activities and five telehealth nursing activities were presented along with three statements: “I consider this a core task of nursing,” “I look forward to becoming trained in this task,” and “I think I will do very well in performing this task.” RESULTS: Internet-generation nursing students (n = 1,113) reported a significantly (p ⩽ .001) less positive view of telehealth activities than of common nursing activities. Median differences were 0.7 (effect size [ES], −0.54), 0.4 (ES, −0.48), and 0.3 (ES, −0.39), measured on a 7-point scale. CONCLUSION: Internet-generation nursing students do not naturally have a positive view of technology-based health care provision. The results emphasize that adequate technology and telehealth education is still needed for nursing students. [J Nurs Educ. 2017;56(12):717–724.]
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Over 40% of nursing home residents in the Netherlands are estimated to have visual impairments. In this study, light conditions in Dutch nursing homes were assessed in terms of horizontal and vertical illuminances and colour temperature. Results showed that in the seven nursing homes vertical illuminances in common rooms fell significantly below the 750 lx reference value in at least 65% of the measurements. Horizontal illuminance measurements in common rooms showed a similar pattern. At least 55% of the measurements were below the 750 lx threshold. The number of measurements at the window zone was significantly higher than the threshold level of 750 lx. Illuminances in the corridors fell significantly below the 200 lx threshold in at least three quarters of the measurements in six of the seven nursing homes. The colour temperature of light fell significantly below the reference value for daylight of 5000 K with median scores of 3400 to 4500 K. A significant difference in colour temperature was found between recently constructed nursing homes and some older homes. Lighting conditions of the examined nursing homes were poor. With these data, nursing home staff have the means to improve the lighting conditions, for instance, by encouraging residents to be seated next to a window when performing a task or during meals.
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Background: Rising healthcare costs, an increasing general practitioner shortage and an aging population have made healthcare organization transformation a priority. To meet these challenges, traditional roles of non-medical members have been reconsidered. Within the domain of physiotherapy, there has been significant interest in Extended Scope Physiotherapy (ESP). Although studies have focused on the perceptions of different stakeholders in relation to ESP, there is a large variety in the interpretation of ESP. Aim: To identify a paradigm of ESP incorporating goals, roles and tasks, to provide a consistent approach for the implementation of ESP in primary care. Methods: An exploratory, qualitative multi-step design was used containing a scoping review, focus groups and semi-structured interviews. The study population consisted of patients, physiotherapists, general practitioners and indirect stakeholders such as lecturers, health insurers and policymakers related to primary care physiotherapy. The main topics discussed in the focus groups and semi-structured interviews were the goals, skills and roles affiliated with ESP. The ‘framework’ method, developed by Ritchie & Spencer, was used as analytical approach to refine the framework. Results: Two focus groups and twelve semi-structured interviews were conducted to explore stakeholder perspectives on ESP in Dutch primary care. A total of 11 physiotherapists, six general practitioners, five patients and four indirect stakeholders participated in the study. There was a lot of support for ‘decreasing healthcare costs’, ‘tackling increased health demand’ and ‘improving healthcare effectiveness’ as main goals of ESP. The most agreement was reached on ‘triaging’, ‘referring to specialists’ and ‘ordering diagnostic imaging’ as tasks fitting for ESP. Most stakeholders also supported ‘working in a multidisciplinary team’, ‘working as a consultant’ and ‘an ESP role separated from a physiotherapist role’ as roles of ESP. Conclusions: Based on the scoping review, focus groups and interviews with direct and indirect stakeholders, it appears that there is sufficient support for ESP in the Netherlands. This study provides a clear presentation of how ESP can be conceptualized in primary care. A pilot focused on determining the feasibility of ESP in Dutch primary care will be the next step.
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