De getallen liegen er niet om: ongeveer een kwart van de Nederlanders heeft beperkte gezondheidsvaardigheden. Dat houdt in dat deze mensen moeite hebben om medische informatie te vinden, te begrijpen en toe te passen. De gevolgen zijn groot: meer ziekenhuisopnames, een slechtere algemene gezondheid en zelfs een hogere mortaliteit. Toch staan we er in de spreekkamer niet vaak bij stil. Wat is onze blinde vlek en wat kunnen we eraan doen?
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Bijna 60 procent van de ouderen heeft beperkte gezondheidsvaardigheden. Fysiotherpeuten hadden de vraag: Welke communicatiestrategieën en tools kunnen (verder) worden ontwikkeld, geëvalueerd en geïmplementeerd in de fysiotherapeutische behandeling voor patiënten met chronische aandoeningen en beperkte gezondheidsvaardigheden, waaronder ouderen?. Om antwoord te geven op deze vraag werden drie methoden gebruikt: een scoping review, design-based research en een feasibility studie. Hieruit kwam een overzicht van bestaande communicatiemiddelen. Hiermee zijn een toolbox met communicatiemiddelen en een training ontwikkeld met een goede bruikbaarheid en acceptatie.
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Background: Shared decision-making is one key element of interprofessional collaboration. Communication is often considered to be the main reason for inefficient or ineffective collaboration. Little is known about group dynamics in the process of shared decision-making in a team with professionals, including the patient or their parent. This study aimed to evaluate just that. Methods: Simulation-based training was provided for groups of medical and allied health profession students from universities across the globe. In an overt ethnographic research design, passive observations were made to ensure careful observations and accurate reporting. The training offered the context to directly experience the behaviors and interactions of a group of people. Results: Overall, 39 different goals were defined in different orders of prioritizing and with different time frames or intervention ideas. Shared decision-making was lacking, and groups chose to convince the parents when a conflict arose. Group dynamics made parents verbally agree with professionals, although their non-verbal communication was not in congruence with that. Conclusions: The outcome and goalsetting of an interprofessional meeting are highly influenced by group dynamics. The vision, structure, process, and results of the meeting are affected by multiple inter- or intrapersonal factors.
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Background: The Turkish translation of the Dutch Talking Touch Screen Questionnaire (TTSQ) has been developed to help physical therapy patients with a Turkish background in the Netherlands to autonomously elucidate their health problems and impairments and set treatment goals, regardless of their level of health literacy. Objective: The aim of this study was to evaluate the usability of the Turkish TTSQ for physical therapy patients with a Turkish background with diverse levels of health literacy and experience in using mobile technology. Methods: The qualitative Three-Step Test-Interview method was carried out to gain insight into the usability of the Turkish TTSQ. A total of 10 physical therapy patients participated. The interview data were analyzed using a thematic content analysis approach aimed at determining the accuracy and completeness with which participants completed the questionnaire (effectiveness), the time it took participants to complete the questionnaire (efficiency), and the extent to which the participants were satisfied with the ease of use of the questionnaire (satisfaction). The problems encountered by the participants in this study were given a severity rating, which was used to provide a rough estimate of the need for additional usability improvements. Results: No participant in this study was able to complete the questionnaire without encountering at least one usability problem. A total of 17 different kinds of problems were found. On the basis of their severity score, 3 problems that should be addressed during future development of the tool were “Not using the navigation function of the photo gallery in Question 4 causing the participant to not see all presented response items;” “Touching the text underneath a photo in Question 4 to select an activity instead of touching the photo itself, causing the activity not to be selected;” and “Pushing too hard or tapping too softly on the touch screen causing the touch screen to not respond.” The data on efficiency within this study were not valid and are, therefore, not reported in this study. No participant was completely satisfied or dissatisfied with the overall ease of use of the Turkish TTSQ. Two participants with no prior experience of using tablet computers felt that, regardless of what kinds of improvement might be made, it would just be too difficult for them to learn to work with the device. Conclusions: As with the Dutch TTSQ, the Turkish TTSQ needs improvement before it can be released. The results of this study confirm the conclusion of the Dutch TTSQ study that participants with low levels of education and little experience in using mobile technology are less able to operate the TTSQ effectively. Using a Dutch speaking interviewer and Turkish interpreter has had a negative effect on data collection in this study.
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Vraag een fysiotherapeut naar allochtone patiënten en de kans is groot dat er een anekdote volgt over communicatieproblemen wegens taalbarrières of cultuurverschillen zoals het anders presenteren van klachten: ‘Alles pijn, u helpen.’ Maar zijn het wel deze punten die voor problemen zorgen of spelen er andere zaken?
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Openbare les van dr. Katerina Jerkovic-Cosic. De belangrijkste mondziekten zoals cariës (tandbederf), parodontitis (tandvleesontsteking) en mondkanker, worden net als welvaartsziekten veroorzaakt door een ongezonde leefstijl en zijn door middel van preventie te voorkomen. Een groot deel van de Nederlandse bevolking gaat minimaal één keer per jaar naar een tandarts of mondhygiënist voor een controle. Toch is mondzorg in Nederland nog steeds veelal gericht op curatie en minder op preventie. Het overgrote deel van de geleverde mondzorg is gericht op herstel, terwijl veel minder activiteiten zijn gericht op het voorkomen van mondziekten, door bijvoorbeeld aanpassing in de leefstijl of mondverzorging. De noodzaak voor preventie wordt steeds duidelijker. Een van de redenen is de enorme stijging van de zorgkosten.
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OBJECTIVE: To provide an overview of available strategies and tools that support physiotherapists to recognise patients with LHL and to adapt the physiotherapeutic communication during the diagnostic phase.METHODS: PubMed, Embase, CINAHL and PsycINFO were searched for publications appearing between 2000 and June 2024. Additional grey literature was searched up till October 2022. Studies were included if they described strategies and tools aimed at supporting communication with patients with Limited Health Literacy in physiotherapy. Exclusion criteria focusing on general health literacy prevalence, behavioural interventions, or basic communication training.RESULTS: Out of the 9960 unique studies identified by our literature searches, 314 full-text studies were assessed and 98 met the inclusion criteria. The data on strategies and tools were extracted into the following six categories: verbal communication (n = 3), written communication (n = 34), digital device (n = 9), questionnaire (n=19), interpreter (n = 22), and other media (n = 2). Within these categories, tools and strategies were further classified based on the communication aims. Some tools and strategies were uncategorisable.CONCLUSION: While various strategies and tools exist for recognising patients with limited Health Literacy, they are often generic and not tailored to the physiotherapeutic context. This scoping review identifies a gab in physiotherapeutic approaches, particularly on those that go beyond information provision.PRACTICE IMPLICATIONS: To improve communication in physiotherapy practice, there is a need for the development of tailored strategies and tools that reflect the specific dynamic of the physiotherapeutic process. We recommend engaging in design-based research that involves both patient and physiotherapist to co-create tools and strategies. In the meantime, physiotherapists are advised to use general communication strategies and tools and refer to our resources to select tools that best align with their specific goals.
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The traditional paternalistic approach in health care is increasingly developing towards a patient-centered care (PCC) approach. However, not all patients are able to take advantage of the positive effects of PCC. Inadequate health literacy (HL) is an important limiting factor in the ability of patients to take on an active role and exchange information with their health care provider effectively. A provenly effective approach to improvement of provider-patient interaction and health outcomes is the use of health-related questionnaires. The aim of the research project described within this thesis was to adapt the most frequently-used questionnaire in Dutch physical therapy practice and add information and communication technology to it. A Dutch and Turkish version of the tool called Talking Touch Screen Questionnaire (TTSQ) was developed and evaluated on both usability and validity aspects. The current prototype of the tool does not yet fully solve the problems native and minority patients with low (health) literacy have with completing the adapted questionnaire. Big challenges in future development and testing the TTSQ are the recruitment of vulnerable members of the hard-to-reach native and minority target populations and finding research methods that suit the abilities and needs of these participants. This is expected to be a very challenging, labor- and time-consuming process. On the other hand, having a usable, valid and reliable TTSQ may well save a lot of time and money in both research and clinical practice in the future.
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In de wereld om ons heen hebben we te maken met data en cijfers. Het vermogen om met getalsmatige informatie om te gaan, heet gecijferdheid. 1 op de 6 inwoners in Nederland heeft moeite met cijfers. De infographic geeft de uitdagingen weer van mensen die in het dagelijks leven moeite hebben met gecijferdheid en laat zien welke factoren een rol spelen bij gecijferdheid.
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Het begrip Ernstige Psychische Aandoening (EPA) is veelomvattend. In de wijk Overvecht, waar gezondheid laag scoort in vergelijking met andere delen van Utrecht, komt EPA veel voor. Overvecht is een wijk die op meer terreinen niet gunstig afsteekt tegen de rest van Utrecht. De sociale cohesie is laag, en ook de hoge graad van mensen met een Turkse of Marokkaanse afkomst is van invloed op de mate waarin mensen gezondheidsrisico lopen. Aanzienlijk minder mensen dan in de rest van Utrecht hebben een baan. Daarmee hangt samen dat veel meer mensen in Overvecht rond moeten komen van een bijstandsuitkering, meer schulden hebben, of moeite hebben om rond te komen met hun inkomen. De eenzaamheid is groter en de tevredenheid over de woonomgeving geringer. Er zijn ook positieve ontwikkelingen en er zijn veel initiatieven in de wijk om de leefbaarheid en gezondheid te verbeteren. Het percentage van mensen met een verslaving is lager, dan in de rest van Utrecht. Een onderzoek uitgevoerd door Vektis bij verschillende instellingen in Utrecht, de zogeheten EPA-vignettenstudie, heeft in kaart gebracht waar mensen met EPA hun behandeling moeten krijgen en waar de regie ligt voor de behandeling.
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