Sandra Zwakhalen

Sandra Zwakhalen
Maastricht University | UM · CAPHRI School for Public Health and Primary Care

About

95
Publications
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Publications

Publications (95)
Article
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Introduction No brief questionnaire comprising knowledge, skills, and attitudes is available to measure digital competence among clinical practice nurses. Objective The aim was to evaluate the structural validity and internal consistency of the Digital Competence Questionnaire (DCQ) for Clinical Practice Nurses. Methods A cross-sectional study wa...
Article
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Aims To describe the co‐creation of the ‘Desired Dementia Care Towards End of Life’ (DEDICATED) approach to improve person‐centred palliative care for individuals with dementia and to describe the experiences of healthcare professionals during the approach's implementation. Methods A needs assessment, comprising both qualitative and quantitative s...
Article
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Background The nursing home residents’ ability to carry out Activities of Daily Living (ADLs) is influenced by the physical care environment. One emerging area of interest in scientific research is the green care environment within nursing home care, where agricultural activities such as gardening and animal care are integrated alongside daily care...
Article
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Introduction: Supporting care receivers in Activities of Daily Living (ADL), irrespective of diagnosis, setting, or cultural background, lies at the heart of fundamental nursing care. The pursuit of quality ADL care becomes increasingly challenging with the changing complexity of care needs. ADL care delivery is often undervalued and is considered...
Article
Full-text available
Clinical practice nurses need adequate digital competence to use technologies appropriately at work. Questionnaires measuring clinical practice nurses' digital competence lack content validity because attitude is not included as a measure of digital competence. The aim of the current study was to identify items for an item pool of a questionnaire t...
Article
Full-text available
Despite its frequent provision, evidence of nursing interventions in Activities of Daily Living (ADL) remains unclear. Hence, we addressed the research question: What are the effects of ADL nursing interventions on independence and comfort in adults across all care settings? We conducted a systematic review of randomized controlled trials and quasi...
Preprint
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Background Care for activities of daily living (ADL) performed by nursing professionals is poorly informed by scientific evidence. To address the nursing professionals’ need for guidance, we developed a clinical practice guideline on ADL care. This guideline comprises key recommendations (KRs) on involving care receivers and informal caregivers in...
Article
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Aim To describe a Delphi study regarding practice variation in needs assessment by Dutch home care nurses, to define practice variation in home care nursing and explore which factors may have a role in this needs assessment. Design A Delphi study was conducted with the participation of home care representatives. Method A Delphi questionnaire was...
Article
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Background Healthcare professionals in nursing homes face complex care demands and nursing staff shortages. As a result, nursing homes are transforming into home-like personalised facilities that deliver person-centred care. These challenges and changes require an interprofessional learning culture in nursing homes, but there is little understandin...
Article
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Background Psychiatric hospitals are increasingly being digitalised. Digitalisation often requires changes at work for health professionals. A positive attitude from health professionals towards technology is crucial for a successful and sustainable digital transformation at work. Nevertheless, insufficient attention is being paid to the health pro...
Article
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Background As long-term care continues to change, the traditional way of learning for work purposes is no longer sufficient. Long-term care organisations need to become ‘learning organisations’ and facilitate workplace learning for nursing staff teams. Therefore, insight is needed into what conditions are important for establishing workplace learni...
Article
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To optimise home care provision and to identify potential improvements in the care process, it is important to gain insight into the care experiences that influence care quality. The aim was to develop a qualitative experienced quality measure for home care in The Netherlands, facilitating conversations between clients and caregivers in generating...
Preprint
Full-text available
BACKGROUND Psychiatric hospitals are increasingly being digitalised. Digitalisation often requires changes at work for health professionals. A positive attitude from health professionals towards technology is crucial for a successful and sustainable digital transformation at work. Nevertheless, insufficient attention is being paid to the health pro...
Article
Full-text available
Background Psychiatric hospitals are becoming increasingly digitized because of the disruptive rise in technical possibilities. This digitization leads to new tasks and demands for health professionals, which can have an impact on technostress. It is unclear whether digital competence reduces technostress and how technostress affects health profess...
Article
Full-text available
Purpose The use of qualitative data to assess quality of care in nursing homes from the resident’s perspective has shown to be valuable, yet more research is needed to determine how this data can be used to gain insight into the quality of care within nursing homes. Whereas it is crucial to stay close to the stories that are the strength of qualita...
Article
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Background The Nurses in the Lead (NitL) programme consists of a systematic approach and training to 1) empower community nurses in implementing evidence, targeted at encouraging functional activities of older adults, and 2) train community nurses in enabling team members to change their practice. This article aims to describe the process evaluatio...
Preprint
BACKGROUND Psychiatric hospitals are becoming increasingly digitized because of the disruptive rise in technical possibilities. This digitization leads to new tasks and demands for health professionals, which can have an impact on technostress. It is unclear whether digital competence reduces technostress and how technostress affects health profess...
Article
The COVID-19 pandemic and its impact on older and frail people underlines the importance of advance care planning (ACP). ACP is a dynamic communication process involving patients, families and healthcare providers, which serves to discuss and document wishes and goals for future care. Currently, ACP practice is often suboptimal. This implies that i...
Article
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Background Communication between nursing staff and people with dementia can be challenging. According to the literature, communication is seen as a process of social- and/or informational exchange between a sender and a receiver in a context. Factors related to these elements determine the quality of communication. Insight into the factors involved...
Article
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Background The acute nature of COVID-19 and its effects on society in terms of social distancing and quarantine regulations affect the provision of palliative care for people with dementia who live in long-term care facilities. The current COVID-19 pandemic poses a challenge to nursing staff, who are in a key position to provide high-quality pallia...
Article
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Aims and Objectives To compare the washing without water method with the water and soap method regarding comfort perceptions of the bed bath. Background Bathing affects nurses’ and care recipients’ comfort. Bedridden care recipients can be bathed in bed with water and soap or with washing without water products. Little is known about the differenc...
Article
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Background To optimize home care, it is essential to determine how care recipients experience quality of care. Traditionally, quality of care is measured with normative quality indicators such as safety, efficiency, or prevalence rates such as falls. The growing interest for qualitative patient-reported experience measures in home care requires ins...
Article
Relaties en interacties tussen bewoners, families en zorgverleners bepalen voor een groot deel hoe kwaliteit van zorg wordt ervaren in verpleeghuizen. Het is belangrijk om inzicht te krijgen in hoe bewoners de kwaliteit van de verpleeghuiszorg ervaren, om zo de kwaliteit te kunnen verbeteren gebaseerd op wat belangrijk is voor hen. Dit vereist een...
Article
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Background: The culture change from task-centered care to person- and relationship-centered care has resulted in the resident’s voice gaining importance when assessing experienced quality of care in nursing homes. This review aimed to identify which factors contribute to experienced quality of care in nursing homes worldwide from the resident’s per...
Article
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Background The culture shift in nursing homes from task-oriented to person-centered care has created a need to assess clients’ experienced quality of care (QoC), as this corresponds best with what matters to them. This study aimed to gain insight into how to assess experienced QoC in nursing homes from the client’s perspective. Method A qualitativ...
Article
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Purpose: This study aimed to evaluate what types and forms of support nursing staff need in providing palliative care for persons with dementia. Another aim was to compare the needs of nursing staff with different educational levels and working in home care or in nursing homes. Design: A cross-sectional, descriptive survey design was used. Meth...
Article
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Activities of Daily Living are a series of basic activities performed by individuals on a daily basis necessary for independent living at home or in the community. ADL are part of basic nursing care which describe aspects of care that are fundamental to all patients’ health and well-being, regardless of diagnosis, cultural background or healthcare...
Article
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Aim: To explore and understand the views of clients and formal and informal caregivers about the experienced quality of home care for older people. Design: A descriptive qualitative study was conducted using individual interviews. Methods: Six home care clients, four formal and six informal caregivers were recruited from two Dutch home care or...
Article
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There is a strong need in long-term care for scientific research, so older people and their families, health care professionals, policy makers, and educators can benefit from new advancements and best available evidence in every day care practice. This paper presents the model of a sustainable and successful interdisciplinary collaboration between...
Article
Background: Nursing staff caring for people with dementia have a crucial role in addressing palliative care needs and identifying changes in health status. Palliative care for people with dementia is complex and requires specific competences. A lack thereof may lead to unnecessary hospitalizations, poor symptom control and undesirable burdensome t...
Article
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Background Having a match between a nursing home and the preferences of people with dementia is beneficial for their well-being. It is suggested that innovative types of nursing homes such as small-scale living facilities and green care farms create a better match between their care environment and their residents. However whether this is also refl...
Article
This article aims to conceptualize experienced quality of post-acute and long-term care for older people as perceived by care recipients. An iterative literature review and consultations with stakeholders led to the development of the INDividually Experienced QUAlity of Long-term care (INDEXQUAL)framework. INDEXQUAL presents the process of an indiv...
Article
“DAIly NURSE” is a recently developed nursing intervention aiming to change nursing staff behavior towards encouraging nursing home residents’ daily activities and independence. A quasi-experimental study was performed on 12 psychogeriatric nursing home wards (7 experimental and 5 control). To evaluate the impact of “DAIly NURSE” on nursing staff b...
Conference Paper
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This study aimed to gain insight into how quality of care in nursing homes (QoC-NHs) should be measured from an individual perspective. A cross-sectional qualitative study consisting of two focus groups and a group exercise with policy makers, (in)formal caregivers and client representatives was performed. Four topics of QoC-NHs were addressed: exp...
Poster
Aim: The aim of this research was to develop a conceptual model presenting elements that influence the experienced quality of long-term care (LTC) as perceived by individual care recipients. It can be used to gain a better understanding of experienced quality in the LTC sector. Method: A scoping review was performed to identify definitions and mode...
Article
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Aims and objectives This study examined the feasibility of DAIly NURSE, a nursing intervention to encourage nursing home residents’ daily activities and independence. Background Nursing home residents are mainly inactive during the day. DAIly NURSE was developed to change nursing behavior towards encouraging nursing home residents’ activities and...
Article
Hypoactive delirium is common among older hospitalised patients: between 29 and 64% of all older patients in hospital develop a delirium, of which the majority is of the hypoactive subtype. Hypoactive delirium often remains undiagnosed or is only diagnosed late and prognosis is worse than for a hyperactive delirium. Psychotic symptoms, fear, and di...
Article
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Background: Delirium is a common and serious complication of hospitalisation in older adults. It can lead to prolonged hospital stay, institutionalisation, and even death. However, it often remains unrecognised or is not managed adequately. The aim of this study was to evaluate the effects of an educational intervention for nursing staff on three...
Article
Aims: The aim of this paper is to describe and discuss the 'Basic Care Revisited' (BCR) research programme, a collaborative initiative that contributes to evidence-based basic nursing care and raises awareness about the importance of basic nursing care activities. Background: While basic nursing care serves nearly all people at some point in the...
Article
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Background: Delirium in older hospitalised patients is a common and serious disorder. Polypharmacy and certain medications are risk factors for developing delirium. A medication review could benefit older hospitalised patients with delirium. Objectives: (1) Evaluate the effects of medication review on length of delirium, length of hospital stay,...
Article
Objective: To estimate the additional societal costs for people living with dementia (PwD) with agitation in home care (HC) and institutional long-term care (ILTC) settings in 8 European countries. Design: Cross-sectional data from the RightTimePlaceCare cohort. Setting: HC and ILTC settings from 8 European countries (Estonia, Finland, France,...
Conference Paper
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This study investigated informal caregivers' psychological well-being and predicted increase in psychological well-being, when caring for persons with dementia (PwDs) living at home, related to caregiver, PwD and formal care (FC) factors. This was a cohort study, at baseline and follow-up in eight European countries. Caregivers included (n=1,223) w...
Article
Aims and objectives: To describe the tailoring of the Tell-us Card intervention for enhanced patient participation to the Dutch hospital setting using Intervention Mapping as a systematic approach. Background: Even though patient participation is essential in any patient-to-nurse encounter, care plans often fail to take patients' preferences int...
Article
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Abstract Background Many countries are introducing smaller, more home-like care facilities that represent a radically new approach to nursing home care for people with dementia. The green care farm is a new type of nursing home developed in the Netherlands. The goal of this study was to compare quality of care, quality of life and related outcomes...
Article
A retrospective cohort study was conducted to research the recognition rates and types of management of delirium in older hospitalized patients. The medical files of all 65+ patients who were diagnosed with a delirium in 2014 in one academic hospital were included in the study (N=401, 5% of all admitted older people). Three quarters of the deliriou...
Article
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Objectives To explore associations between carer burden and characteristics of (1) the informal carer, (2) the person with dementia, and (3) the care support network in 8 European countries. Design Cross-sectional study. Setting People with dementia judged at risk of admission to long-term care (LTC) facilities in 8 European countries (Estonia, F...
Chapter
Pain in dementia is a frequent occurring problem. This chapter provides insight in the challenges and opportunities of assessing and managing pain in older people with dementia. The patient’s self-report reflects the older persons’ subjective experience of pain the best. However due to the communicative and cognitive problems, the use of self-repor...
Book
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A free sample reading can be found in google books (https://books.google.at/). You can buy the book on following homepage: http://www.springer.com/gp/book/9783319498300 It is available as eBook and as Hardcover. Written by leading international experts, this book discusses the latest advances in the field of dementia in nursing homes. The topics a...
Article
Background: In order to contain public health care spending, European countries attempt to promote informal caregiving. However, such a cost reducing strategy will only be successful if informal caregiving is a substitute for formal health care services. We therefore analyze the effect of informal caregiving for people with dementia on the use of...
Article
Full-text available
Objectives: The objectives of the study are to study daily hospital practice regarding detection and management and to study hyperactive and hypoactive delirium of older patients during their hospitalization. Methods: A retrospective cohort study evaluating care as usual for older hospitalized patients with delirium at Maastricht University Medi...
Article
Objectives: Innovative care environments are developed for people with dementia to encourage person-centered care. This study aims to investigate whether residents of green care farms that provide 24-hour nursing care participate more in (physical) activities and social interaction compared with residents of other nursing homes. Design: Longitud...
Article
Full-text available
Background For immobile patients, a body wash in bed is sometimes the only bathing option. Traditionally, the bed bath is performed with water and soap. However, alternatives are increasingly used in health care. Washing without water is one such alternative that has been claimed to offer several advantages, such as improved hygiene and skin condit...
Article
Purpose: The shift in nursing home care for patients with dementia from traditional task-driven environments towards patient-centered small-scale environments has implications for nursing practice. Information about its implications for nursing staff is lacking, and only a few studies have addressed staff perceptions. We sought to explore staff pe...
Article
The aim of this cross-sectional study was to explore the role of nursing staff in residents' activities. Nursing home residents (n = 723) were observed in their wards, randomly five times for one minute between 7 a.m. and 11 p.m. Resident's (in)activity and the role of nursing staff or others in this activity were recorded. Roles were defined as ‘t...
Article
Background: To provide adequate nursing care it is important for nursing staff to communicate effectively with people with dementia. Due to their limited communication skills, people with dementia have difficulties in understanding communication and expressing themselves verbally. Nursing staff members often report communication difficulties with...
Article
Background: Daily life is a dynamic and multidimensional concept, for which appropriate assessment tools are lacking. This study describes the development of the Maastricht Electronic Daily Life Observation tool (MEDLO-tool), a freely accessible, easy to use, electronic observation tool to assess relevant daily life aspects for nursing home reside...
Article
Objective: Delirium is a serious and common complication among older hospitalized patients and is a predictor of many adverse outcomes. However, up to 72% of delirium incidents are unrecognized or misdiagnosed. The aim of this systematic review is to determine the validity, reliability, and feasibility of instruments for the detection of delirium...
Article
Full-text available
Background: In nursing home care, new care environments directed towards small-scale and homelike environments are developing. The green care farm, which provides 24-h nursing home care for people with dementia, is one such new care environment. Knowledge is needed on the relation between environmental features of green care farms such as nature, d...
Article
Background: Informal (dementia) care has economic consequences throughout the health care system. Whilst the health and wellbeing of the care recipient might improve, the health of the caregiver might also change, typically for the worse. Therefore, this analysis aims to examine the association between caregiving intensity and caregivers' health a...
Article
Objectives: Research shows that nursing home residents are largely inactive. This inactivity negatively influences physical fitness, and participation in daily activities is known to have a positive influence on physical function and quality of life. Existing research does not provide sufficient insight into the daily activities in which nursing h...
Article
Dementia is associated with high costs of national healthcare in European countries. Among behavioral disorders associated observed in the elderly with dementia, agitation and aggression (A/A) are very common neuropsychiatric symptom and burdensome for society. These disorders affect between 40% and 60% of people with dementia (PwD), according to t...
Article
AimTo assess which factors are associated with change in quality of life of people with dementia who have recently been admitted to long-term care facilities.Background Many people with dementia will be admitted to long-term care facilities at some point during their disease. It is currently unknown which factors are associated with improvement and...
Article
Background: Small-scale, home-like care environments are increasingly implemented in institutional nursing care as a model to promote resident-directed care, although evidence on its effects is sparse. This study focuses on the effects of small-scale living facilities on the behavior of residents with dementia and use of physical restraints and ps...
Article
The purpose of this study was twofold: 1) to evaluate four pain assessment tools for use with long-term care (LTC) residents who were both able and not able to verbally report their pain; and 2) to assess whether pain behaviors displayed by LTC residents vary as a function of ability to self-report pain. We examined the differences between these tw...
Article
Background: Quality of life has become an important outcome measure in dementia research. Currently there is no convincing evidence about which factors are associated with quality of life of people with dementia living in long-term care facilities. Objective: This study aims to investigate which factors are associated with quality of life, inclu...
Article
To investigate the feasibility of regular pain assessment using an observational scale in nursing home residents with dementia and; determine interventions applied after diagnosing possible pain. Pain occurs regularly among nursing home residents with dementia and is frequently undertreated. Over the last decade a variety of observational scales ha...
Article
Pain assessment and management in older adults requires a special emphasis on the needs of this population, which is often not considered within general education. The purpose of this study was twofold: to determine the availability of education on pain in older adults around the world, and to present a review and synthesis of published guidelines...
Article
Background: Current developments in institutional dementia care aim at the downsizing of facilities and increasing their homelike appearance. Small-scale living facilities are an example of this movement, in which a small group of residents (usually six to eight) live together in a homelike environment. Residents are encouraged to participate in n...
Article
Full-text available
According to traditional conceptualizations of the relationship between fear of falling and falls in older adults, fear of falling is considered to be predictive of falls because it leads to activity avoidance which, in turn, leads to de-conditioning that increases fall risk. The recent literature has begun to challenge such conceptualizations. Spe...
Article
We sought to determine a cutoff score for the observational Pain Assessment in Advanced Dementia (PAINAD), to adequately assess pain in clinical nursing home practice and research. We used data from multiple sources. We performed a literature review on PAINAD, performed secondary data analysis of a study examining psychometric properties of PAINAD...
Article
The purpose of this study was to evaluate the effects of small-scale living facilities in dementia care on residents, family caregivers, and staff. This was a quasi-experimental study including 2 types of institutional nursing care: small-scale living facilities (experimental group), and regular psychogeriatric nursing home wards (control group). T...
Article
Full-text available
Nursing home care for people with dementia is increasingly organized in small-scale and homelike care settings, in which normal daily life is emphasized. Despite this increase, relatively little is known about residents' characteristics and whether these differ from residents in traditional nursing homes. This study explored and compared characteri...