Background: Optimizing transitional care by practicing family-centered care might reduce unplanned events for patients who undergo major abdominal cancer surgery. However, it remains unknown whether involving family caregivers in patients’ healthcare also has negative consequences for patient safety. This study assessed the safety of family involvement in patients’ healthcare by examining the cause of unplanned events in patients who participated in a family involvement program (FIP) after major abdominal cancer surgery. Methods: This is a secondary analysis focusing on the intervention group of a prospective cohort study conducted in the Netherlands. Data were collected from April 2019 to May 2022. Participants in the intervention group were patients who engaged in a FIP. Unplanned events were analyzed, and root causes were identified using the medical version of a prevention- and recovery-information system for monitoring and analysis (PRISMA) that analyses unintended events in healthcare. Unplanned events were compared between patients who received care from family caregivers and patients who received professional at-home care after discharge. A Mann-Whitney U test was used to analyze data. Results: Of the 152 FIP participants, 68 experienced an unplanned event and were included. 112 unplanned events occurred with 145 root causes since some unplanned events had several root causes. Most root causes of unplanned events were patient-related factors (n = 109, 75%), such as patient characteristics and disease-related factors. No root causes due to inadequate healthcare from the family caregiver were identified. Unplanned events did not differ statistically (interquartile range 1–2) (p = 0.35) between patients who received care from trained family caregivers and those who received professional at-home care after discharge. Conclusion: Based on the insights from the root-cause analysis in this prospective multicenter study, it appears that unplanned emergency room visits and hospital readmissions are not related to the active involvement of family caregivers in surgical follow-up care. Moreover, surgical follow-up care by trained family caregivers during hospitalization was not associated with increased rates of unplanned adverse events. Hence, the concept of active family involvement by proficiently trained family caregivers in postoperative care appears safe and feasible for patients undergoing major abdominal surgery.
Background: Engaging families in postsurgical care is potentially beneficial for improving cancer patient outcomes and quality of care. The authors developed a family involvement program (FIP) and in this study, the authors aim to evaluate the impact of the FIP on family caregiver burden and well-being. Moreover, the authors aim to assess the fidelity of the program. Materials and methods: This is a preplanned subgroup analysis of a patient-preferred prospective cohort study that included family caregivers of patients who underwent major oncological surgery for gastrointestinal tumors. Only patient-nominated family caregivers could participate in the FIP. Caregivers received structured training in fundamental caregiving tasks from healthcare professionals and then actively participated in these tasks. Caregiver burden and well-being were measured four times (at hospital admission, at hospital discharge, and at 1 and 3 months posthospital discharge) using the Caregiver Strain Index+ (CSI+) and the Care-related Quality of Life instrument (CarerQoL-7D). The fidelity of the FIP was assessed by recording completion of care activities. In addition, family caregivers were asked whether they would participate in the FIP again. Results: Most of the 152 family caregivers were female (77.6%), and their mean age was 61.3 years (SD=11.6). Median CSI+ scores ranged between -1 and 0 and remained below the cutoff point of experiencing burden. CarerQoL-7D results indicated no significant differences in family caregivers' well-being over time. Upon discharge, over 75% of the family caregivers stated that they would recommend the FIP to others. The highest compliance with all fundamental care activities was observed during postoperative days 2-4. Conclusion: The family caregivers of oncological surgical patients who participated in the FIP exhibited acceptable levels of caregiver burden and well-being. These findings suggest that the FIP is a valuable intervention to equip family caregivers with the skills to navigate the uncertain period following a patient's hospital discharge.
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Background Family participation in essential care may benefit patients and relatives. Aims To examine the needs, perceptions and preferences of health care providers about family participation in essential care in the adult intensive care unit. Study design A qualitative descriptive study using inductive thematic analysis. Three focus group interviews with a total of 30 intensive care unit health care providers, consisting of 20 critical care nurses, one nursing assistant, five physicians, three physical therapists and one speech therapist working in three Dutch intensive care units.
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Family Dairy Tech Sustainable and affordable stable management systems for family dairy farms in India. An example of Dutch technology that is useful to an ?emerging economy?. Summary Problem The demand for dairy products in India is increasing. Small and medium-sized family farmers want to capitalize on this development and the Indian government wants to support them. Dutch companies offer knowledge and a wide range of products and services to improve dairy housing systems and better milk quality, in which India is interested. However, the Dutch technology is sophisticated and expensive. For a successful entry into this market, entrepreneurs have to develop affordable and robust (?frugal?) systems and products adapted to the Indian climate and market conditions. The external question is therefore: ?How can Dutch companies specialised on dairy housing systems adapt their products and offer these on the Indian market to contribute to sustainable and profitable local dairy farming??. Goal Since 2011, VHL University of Applied Sciences (VHL) is collaborating with a college and an agricultural information center Krishi Vigyan Kendra (KVK), Baramati, Pune district, Maharashtra State India. In this region many small-scale dairy farmers are active. Within this project, KVK wants to support farmers to scale up their farm form one or a few cows up to 15 to 100 cows, with a better milk quality. In this innovative project, VHL and Saxion Universities of Applied Sciences, in collaboration with KVK and several Dutch companies want to develop integrated solutions for the growing number of dairy farms in the State of Maharashtra, India. The research questions are: 1. "How can, by smart combinations of existing and new technologies, the cow-varieties and milk- and stable-management systems in Baramati, India, for family farmers be optimized in an affordable and sustainable way?" 2. "What are potential markets in India for Dutch companies in the field of stable management and which innovative business models can support entering this market?" Results The intended results are: 1. A design of an integral stable management system for small and medium-sized dairy farms in India, composed of modified Dutch technologies. 2. A cattle improvement programme for robust cows that are adapted to the conditions of Maharashtra. 3. An advice to Dutch entrepreneurs how to develop their market position in India for their technologies. 4. An advice to Indian family farmers how they can increase their margins in a sustainable way by employing innovative technologies.
