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Introduction
JB is (a retired) researcher in the Maastricht University Medical Center. Her special interest and expertise is innovation of heart failure care i.e. e-health, integrated care and palliative care. She has been involved in several (inter)national projects, focussing on e-health, heart failure hospitalisation at home, burden and needs of informal caregivers, and palliative care.
Additional affiliations
September 2007 - December 2013
January 2000 - present
September 2007 - present
Position
- Telemonitoring in patients with heart failure
Description
- Three hospitals in the South of the Netherlands are included in the TEHAF-study and 382 patients are participating. Currently analysis and publications are performed.
Education
September 2002 - June 2004
Publications
Publications (83)
Background
eHealth products have the potential to enhance heart failure (HF) care by identifying at-risk patients. However, existing risk models perform modestly and require extensive data, limiting their practical application in clinical settings. This study aims to address this gap by validating a more suitable risk model for eHealth integration....
Background
Heart failure (HF) is a chronic disease characterized by high mortality and healthcare expenditures. Digital health solutions, including mobile health applications (apps), offer opportunities to enhance patients’ self-care and quality of life. This qualitative study aimed to explore expectations, experiences, and usage behaviour of HF-pa...
Background
Effective self-care in heart failure (HF) is essential to prevent acute deterioration and improve treatment adherence and quality of life. The supportive role of eHealth is becoming increasingly important to alert HF patients to changes in symptoms and take greater responsibility for maintaining or improving their state of health. Integr...
Aims
This study aims to (i) test the validity and reliability of the Care Dependency Scale (CDS) for patients with heart failure (HF) and (ii) test the validity and reliability of the proxy version of the CDS assessing informal caregivers’ perception of the dependency level of individuals with HF.
Methods and results
Secondary data analysis was co...
Aim
This paper describes the trajectory during 1 year of four patient‐reported outcomes (PROs), namely, sleep, depressive symptoms, health‐related quality of life (HrQoL), and well‐being, in patients with heart failure (HF), their relationship and the patient characteristics associated with changes in these PROs.
Methods and results
Data analyses...
Background. Caregivers are crucial in ensuring that their relatives with heart failure (HF) reach proper self-care levels. Despite this, the demanding nature of caring for others can lead to poor outcomes and the compromise of own needs, which raises the need for perceived social support. Prior research does not offer a thorough knowledge of how ca...
Aims
To develop a comprehensive understanding of caregiver burden and its predictors from a dyadic perspective.
Method
A convergent mixed methods design was used. This study was conducted in three European countries, Italy, Spain, and the Netherlands. A sample of 229 HF patients and caregivers was enrolled between February 2017 and December 2018 f...
Background:
Informal caregivers contribute substantially to the self-care of people with heart failure (HF) by helping with concrete and interpersonal tasks. Time perception and management are essential issues among caregivers. However, investigators have not explored this topic in caregivers of people with HF.
Objectives:
The aim of this study...
Aims:
Heart failure (HF) is a common cause of mortality and (re)hospitalisations. The NWE-Chance project explored the feasibility of providing hospitalisations at home (HH) supported by a newly developed digital health platform. The aim of this study was to explore the perceived usability by healthcare professionals (HCPs) of a digital platform in...
Background:
In Europe, more than 15 million people live with heart failure (HF). It imposes an enormous social, organizational and economic burden. As a reaction to impending impact on healthcare provision, different country-specific structures for HF-care have been established. The aim of this report is to provide an overview and compare the HF-c...
Background
Heart failure is a severe condition and telemedicine can improve the care of heart failure. Many patients are unable to use telemedicine applications due to visual impairment and limited health-related literacy. Avatar technology might help to overcome these limitations.
Methods
A telemedicine application was combined with a nurse avata...
Background
Hospitalisations for heart failure are frequent and costly, linked with a lower quality of life, and lead to higher morbidity and mortality. Home hospitalisation interventions could be a substitute for in-hospital stays to reduce the burden on patients. The current study aims to investigate patient-reported satisfaction and usability in...
Introduction: Caregivers play an instrumental role in ensuring adequate self-care for their relatives with heart failure (HF). Nevertheless, caregivers can be subject to negative outcomes and sacrifice of personal needs due to their challenging caregiving role, which increases the demand for social support. Previous studies did not provide a compre...
Aim:
To discuss the changing role of patients, nurses and doctors in an era of digital health and heart failure care.
Background:
With a growing demand for heart failure care and a shortage of health care professionals to meet it, digital technologies offer a potential solution to overcoming these challenges.
Evaluation:
In reviewing pertinent...
Introduction
Heart failure (HF) poses a burden on specialist care, making referral of clinically stable HF patients to primary care a desirable goal. However, a structured approach to guide patient referral is lacking.
Methods
The Maastricht Instability Score–Heart Failure (MIS-HF) questionnaire was developed to objectively stratify the clinical s...
Background
In order to manage Heart Failure (HF) properly, both pharmacological and non-pharmacological interventions including patient education and self-care (SC) support are important. Appropriate health care (HC) professional support is necessary to improve patient SC-skills. However, little is known which HC-professionals deliver specific educ...
Aims
To explore caregivers' needs and problems in three European countries and associate the clusters of caregivers' needs with their sociodemographic characteristics.
Design
A qualitative focused mixed methods design was used.
Methods
In total, 52 caregivers of heart failure (HF) people were interviewed in three European countries between March...
Introduction
To alleviate the burden of Heart Failure (HF), the European Society of cardiology developed guidelines (ESC-guidelines) to optimise HF-diagnosis and treatment. These guidelines state that optimal HF-care is organised in a multidisciplinary programme in which pharmacological and non-pharmacological treatment is offered. Research has pro...
Introduction
Heart failure (HF) poses a burden on specialist care, making referral of clinically stable HF patients to primary care a desirable goal. However, a structured approach to guide patient referral is lacking.
Methods
The Maastricht Instability Score—Heart Failure (MIS-HF) questionnaire was developed to objectively stratify the clinical s...
Background
Needs assessment tools can facilitate healthcare professionals in timely recognition of palliative care needs. Despite the increased attention for implementation of such tools, most studies provide little or no attention to the context of implementation. The aim of this study was to explore factors that contribute positively and negative...
Background:
Heart failure (HF) is a common cause of hospitalisation and mortality in elderly. The frequent rehospitalisations put a serious burden on patients, health-care budgets, and health-care capacity. Frequent hospital admissions are also associated with a substantial additional hazard for serious complications and reduced quality of life. T...
Introduction: Caring for relatives with heart failure is emotionally and physically intensive for informal caregivers leading to caregiver burden. Evidence also suggests that caregiver burden affects the quality of life of both components of the patient-caregiver dyad. Previous research provides a limited understanding of the nature of caregiver bu...
Aim:
To develop a comprehensive understanding of resilience and its associated factors among informal caregivers of people with heart failure.
Design:
Transnational multicentre convergent mixed methods approach.
Methods:
This study was conducted in three European countries: Italy, Spain and the Netherlands; during February 2017 and December 20...
Introduction
Heart failure is a serious burden on health care systems due to frequent hospital admissions. Early recognition of outpatients at risk for clinical deterioration could prevent hospitalization. Still, the role of signs and symptoms in monitoring heart failure patients is not clear. The heart failure coach is a web-based telemonitoring a...
Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): HFA Nurse training Fellowship Award Center for Excellence for Culture and Nursing Research (CECRI)Nursing Scholarship OPI Rome Italy
Introduction
Resilience is a dynamic process of utilising abilities to harness personal, social, and spir...
Background
The European Heart Failure Self-Care Behaviour Scale (EHFScBS) is used worldwide to measure heart failure (HF) patient self-care, but a caregiver version does not exist.
Objective
To develop and test the European HF Self-Care Behaviour Scale for Caregivers (EHFScBS-C) in a population of informal caregivers of HF patients.
Methods
The E...
Introduction
Healthcare professionals (HCPs) experience difficulties in timely recognising and directing palliative care (PC) needs of their patients with chronic heart failure (CHF). The aim of this study was to develop a comprehensive tool to enable HCPs in timely recognising and directing PC needs in CHF.
Methods
A four-stage mixed-method study...
Background
The delivery of palliative care interventions is not widely integrated in chronic heart failure care as the recognition of palliative care needs is perceived as difficult. Tools may facilitate healthcare professionals to identify patients with palliative care needs in advanced chronic heart failure.
Aim
To identify tools to help healthc...
The Heart Failure Association of the European Society of Cardiology has published a previous position paper and various guidelines over the past decade recognizing the value of palliative care for those affected by this burdensome condition. Integrating palliative care into evidence-based heart failure management remains challenging for many profes...
In March 2020, the World Health Organisation
declared COVID-19 as a global pandemic. Patients
with cardiovascular conditions, including heart failure
(HF), are disproportionately impacted by this new disease. Escalating mortality figures and pressures on staff
and resources have challenged us on how best to support those affected, and how to deal w...
Background
Palliative care can improve outcomes for patients with advanced chronic heart failure and their families, but timely recognition of palliative care needs remains challenging.
Aim
The aim of this study was to identify characteristics of a tool to assess palliative care needs in chronic heart failure that are needed for successful impleme...
Aims
Exergaming is a new tool to increase physical activity. This study aimed to determine the effects of access to a home‐based exergame (Nintendo Wii) in patients with heart failure (HF) on exercise capacity, self‐reported physical activity and patient‐reported outcome measures.
Methods and results
We enrolled 605 HF patients in New York Heart A...
Aims:
Cognitive impairment (CI) in heart failure (HF) patients has mostly been studied in single countries in specific health care settings. Sociodemographic and clinical predictors of the global CI and CI dimensions are still unclear. We described CI in a diverse HF population recruited in several countries and in different health care settings a...
Heart failure (HF) is one of the most complex chronic disorders with high prevalence, mainly due to the ageing population and better treatment of underlying diseases. Prevalence will continue to rise and is estimated to reach 3% of the population in Western countries by 2025. It is the most important cause of hospitalisation in subjects aged 65 yea...
Background
Functional status and health-related quality of life (HRQoL) are important in patients with heart failure (HF). Little is known about the effect of telemonitoring on functional status and HRQoL in that population.
Methods and results
A total of 382 patients with HF (New York Heart Association class 2–4) were included in a randomised con...
Background Functional status and health-related quality of life (HRQoL) are important in patients with J.J.J. Boyne and C. Knackstedt contributed equally to this work. The work was performed at the heart failure (HF). Little is known about the effect of telemonitoring on functional status and HRQoL in that population. Methods and results A total of...
Aims
The European Society of Cardiology (ESC) guidelines state that heart failure nurse specialists (heart-failure nurses) with specific competences are essential for a successful heart-failure-management programme. Thus, the Heart Failure Association (HFA) of the ESC developed the heart failure nurse curriculum (HFA curriculum). Several ESC member...
Background:
The Needs Assessment Tool: Progressive Disease - Heart Failure (NAT:PD-HF) was developed to identify and triage palliative care needs in patients with chronic heart failure. A Dutch version is currently lacking.
Aims:
The aim of this study was to investigate the feasibility and acceptability of a Dutch NAT:PD-HF in chronic heart fail...
Telemedicine in chronic diseases like heart failure is rapidly evolving and has two important goals: improving and individualising care as well as reducing costs. In this paper, we provide a critical and an updated review of the current evidence by discussing the most important trials, meta-analyses and systematic reviews. So far, evidence for the...
Introduction:
Evidence suggests that telemonitoring decreases mortality and heart failure (HF)-related hospital admission in patients with HF. However, most studies follow their patients for only several months. Little is known about the long-term effects of telemonitoring after a period of application.
Methods:
In 2007, the TEHAF study was init...
Heart failure is a complex disease with poor outcome. This complexity may prevent care providers from covering all aspects of care. This could not only be relevant for individual patient care, but also for care organisation. Disease management programmes applying a multidisciplinary approach are recommended to improve heart failure care. However, t...
Background
Heart failure (HF) may influence the lungs and vice versa. However, this interaction and the influence on right ventricular function (RVF) are insufficiently described in patients with HF divided into the recent groups based on left ventricular ejection fraction (LVEF): HF with reduced, midrange and preserved ejection fraction (HFrEF, HF...
Background
Comorbidities are common in chronic heart failure (HF) patients, but diagnoses are often not based on objective testing. Chronic obstructive pulmonary disease (COPD) is an important comorbidity and often neglected because of shared symptoms and risk factors. Precise prevalence and consequences are not well known. Therefore, we investigat...
Decompensatio cordis wordt ook wel hartfalen genoemd. Het betreft de situatie waarbij het hart – door een verminderde pompfunctie – niet meer in staat is voldoende bloed het lichaam in te pompen. Daardoor ontvangen de organen in het lichaam onvoldoende zuurstof en voedingsstoffen.
Exercise is known to be beneficial for patients with heart failure (HF), and these patients should therefore be routinely advised to exercise and to be or to become physically active. Despite the beneficial effects of exercise such as improved functional capacity and favourable clinical outcomes, the level of daily physical activity in most patient...
Telemonitoring positively influences some aspects of quality of life. Furthermore it reduces patients' depression and anxiety scores on the short run. The current article presents the results of a one year follow-up study regarding the impact of a first generation telemonitoring system on depression and Quality of Life scores in patients with heart...
We examined the incremental cost-effectiveness of telemonitoring (TM) versus usual care (UC) in patients with congestive heart failure (CHF). In one university and two general hospitals, 382 patients were randomised to usual care or telemonitoring and followed for 1 year. Hospital-related and home costs were estimated, based on resource use multipl...
Background: This study represents the cost effectiveness results of a telemonitoring system compared with care as usual.
Methods: In one university and two general hospitals, 382 patients with heart failure were randomised to usual care or telemonitoring and followed for 1 year (the TEHAF study). Hospital related costs and costs in the home situati...
The increasing prevalence of chronic diseases, such as heart failure, presents a substantial challenge to healthcare systems. Telemonitoring is believed to be a useful instrument in the delivery of heart failure care. However, a widespread use of telemonitoring is currently failing for various reasons. This article provides an overview of the barri...
Background:The education of patients with heart failure (HF) is an essential part of disease management. The perspectives of an increasing number of patients and a shortage of professionals force healthcare to explore new strategies in supporting patients to be better informed and more active.Methods:Three hundred and eighty-two patients with HF (a...
Recent increases in heart failure tend to overload the healthcare system. Consequently, there is a need for innovative strategies to reduce heart failure hospitalizations.
A multicentre randomized controlled trial was carried out to test the hypothesis that telemonitoring reduces heart failure hospitalizations during 1 year follow-up. The mean age...
Aims Recent increases in heart failure tend to overload the healthcare system. Consequently, there is a need for innovative strategies to reduce heart failure hospitalizations. Methods and results A multicentre randomized controlled trial was carried out to test the hypothesis that telemonitoring reduces heart failure hospitalizations during 1 year...
Background
Recent increasing prevalence of heart failure (HF) patients leads to an increasing burden to the health care system. Consequently, there is a need for innovative strategies to reduce HF hospitalizations.
Methods
We performed a multicentre randomized controlled trial to test the hypothesis that telemonitoring in patients with HF, by mean...
As the prevalence of heart failure (HF) rises sharply, the costs related to the care of these patients increases in parallel. Considering the already limited resources and manpower, in the future the demand for care may exceed the supply. Therefore, health care systems are encouraged to develop innovative strategies to deal with the burden of HF to...
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Aims: Recent increases in heart failure tend to overload the healthcare system. Consequently, there is a need for innovative
strategies to reduce heart failure hospitalizations.
Methods and results: A multicentre randomized controlled trial was carried out to test the hypothesis that telemonitoring reduces heart
failure hospitalizations during 1 ye...
This paper reports on of the effects of the Chronic Disease Self-Management Programme on psychosocial attributes, self-care behaviour and quality of life among congestive heart failure patients who experienced slight to marked limitation of physical activity.
Most self-management programmes for congestive heart failure patients emphasize the medica...
Purpose: Adherence among HF patients is an important process indicator for outcomes such as hospitalizations, morbidity and mortality. The potential of telemonitoring to improve patients' adherence is analyzed. Accordingly, the role of disease specific knowledge and depression are also studied.
Methods: 101 patients from three Dutch hospitals are i...
The Chronic Disease Self-Management Programme (CDSMP)was recently evaluated among patients with congestive heart failure (CHF) in a randomized controlled trial (n = 317) with twelve months of follow-up after the start of the programme. That trial demonstrated short-term improvements in cardiac-specific quality of life. The current study assessed wh...
This study assessed the feasibility of the Chronic Disease Self-Management Program (CDSMP) among patients with congestive heart failure (CHF). The program emphasizes patients' central role and responsibility in managing their illness.
Patients were randomly assigned to the program, which was led by a cardiac nurse specialist and a CHF patient. Data...
In many healthcare systems, the outcomes of care for patients with heart failure (HF) are in need of improvement. By applying telemonitoring, this study aimed to assess its short-term impact on patients' disease-specific knowledge, adherence, and depression. As part of a larger trial (N = 1,023, 17 centers), this study reports preliminary findings...
The 'Chronic Disease Self-Management Programme' (CDSMP) emphasizes patients' responsibility for the day-to-day management of their condition(s) and has shown favourable effects on health behaviour and healthcare utilization among various groups of patients with chronic conditions. However, the effects of the CDSMP among congestive heart failure (CH...
Decompensatio cordis wordt ook wel hartfalen genoemd. Het betreft de situatie waarbij het hart – door een verminderde pompfunctie
– niet meer in staat is voldoende bloed het lichaam in te pompen. Daardoor ontvangen de organen in het lichaam onvoldoende
zuurstof en voedingsstoffen.