Josien Engel

Josien Engel
Utrecht University of Applied Sciences, Netherlands, Utrecht · Faculty of Healthcare

Doctor of Philosophy

About

19
Publications
1,757
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111
Citations

Publications

Publications (19)
Article
Full-text available
In the Dutch nursing context, work remains in strengthening the voice of nurses serving as frontline health care providers and board members alike. Conceptual clarity of Public Opinion Leadership (POL) in nursing practice is needed to provide attributes, antecedents and consequences for nurses and nurse leaders so they can contribute in the public...
Chapter
De ‘realist evaluation’ richt zich op de aanwezige context en de onderliggende mechanismen en probeert te verklaren waarom een complexe interventie werkt (of juist niet). Belangrijke vragen zijn dan ook wat werkt, voor wie, in welke mate, in welke context, over welke periode en waarom? Met een realist evaluation probeer je een antwoord te vinden op...
Article
Full-text available
Objective Cardiac guidelines recommend that the decision to perform coronary angiography (CA) in patients with Non-ST-Elevation Acute Coronary Syndrome (NST-ACS) is based on multiple factors. It is, however, unknown how cardiologists weigh these factors in their decision-making. The aim was to investigate the importance of different clinical charac...
Article
Full-text available
Background: In the management of non-ST-elevation acute coronary syndrome (NST-ACS) a gap between guideline-recommended care and actual practice has been reported. A systematic overview of the actual extent of this gap, its potential impact on patient-outcomes, and influential factors is lacking. Objective: To examine the extent of guideline adh...
Article
Full-text available
Objectives Quantitative risk assessment in unstable angina (UA) and non-ST-elevation myocardial infarction (NSTEMI), by using cardiac risk scores, is recommended in international guidelines. However, a gap between recommended care and actual practice exists, as these instruments seem underused in practice. The present study aimed to determine the e...
Article
Full-text available
To assess the comparability of five performance indicator scores for treatment delay among patients diagnosed with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention in relation to the quality of the underlying data. Secondary analyses were performed on data from 1017 patients in seven Dutch hos...
Article
Full-text available
Introduction Cardiologists face the difficult task of rapidly distinguishing cardiac-related chest pain from other conditions, and to thoroughly consider whether invasive diagnostic procedures or treatments are indicated. The use of cardiac risk-scoring instruments has been recommended in international cardiac guidelines. However, it is unknown to...
Article
Full-text available
Background: Cardiac risk scores estimate a patient's risk of future cardiac events or death. They are developed to inform treatment decisions of patients diagnosed with unstable angina or non-ST-elevation myocardial infarction. Despite recommending their use in guidelines and evidence of their prognostic value, they seem underused in practice. The...
Article
Full-text available
Background Increasing guideline adherence in the management of acute coronary syndrome (ACS) in hospitals potentially reduces heart failure and mortality. Therefore, an expert panel identified three guideline recommendations as the most important aims for improvement in ACS care, i.e. timely invasive treatment, use of risk scoring instruments and p...

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