February 2025
TVZ - Verpleegkunde in praktijk en wetenschap
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February 2025
TVZ - Verpleegkunde in praktijk en wetenschap
December 2024
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1 Read
TVZ - Verpleegkunde in praktijk en wetenschap
October 2024
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11 Reads
BMC Geriatrics
Background Older adults account for a large proportion of hospital admissions. In this study we aim to bridge a gap between medical and psychosocial factors in predicting hospitalisation. Methods Demographic and social characteristics of community-dwelling pre-frail and frail older people were collected by questionnaires every six months during a two year follow-up. Hospital admission within this period was dichotomised as yes/no. To define pre-frailty and frailty the Fried frailty criteria were used. Analysis of risk factors for hospitalisation was performed using multivariable logistic regression. Results Hospitalised participants (n = 1803) were more often male and frail in comparison to not-hospitalised participants. They also experienced more chronic diseases (54.5% ≥ 4 chronic diseases), poorer self-perceived health (SPH) (76.4% fair to very poor) and lack of informal care (20.1%). In multivariable logistic regression male gender (Odds ratio (OR) 1.65, p < 0.001), frailty (vs. pre-frailty) (OR 1.66, p = 0.002), reporting lower SPH (OR 3.12, p < 0.001) and lacking informal care (OR 1.69, p < 0.001) showed significant associations with hospital admission. Subgroup analysis of pre-frail and frail participants, showed consistent associations between male gender (respectively OR 1.61, p < 0.001 ; OR 1.72, p = 0.085), lower SPH (OR 2.23, p = 0.001; OR 31.16, p < 0.001), lack of informal care (OR 1.64, p = 0.005; OR 2.63, p = 0.012) and hospitalisation. Conclusion Frailty, male gender, lower SPH and lack of informal care are risk factors for hospitalisation within community-dwelling older people, showing the need of a holistic approach to possibly prevent hospitalisation. Further research should focus on evaluating individual factors for hospitalisation, particularly targeting pre-frail individuals.
December 2023
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65 Reads
International Journal of Integrated Care
Demand for long-term care is rising, because of the aging of the population and the increase in chronic and degenerative diseases. Both community and institutional care services are facing challenges, not only caused by aggregated care needs but also through technological and related health care innovations. At the same time, the number of well-trained staff is decreasing, partly due to a negative image of care provision within the field of geriatrics. Innovations that address the changing needs and demands of the future are highly warranted and there is a strong need to develop and implement evidence-based practice and technology. Unfortunately, it may take on average up to 17 years before scientific knowledge is adopted in daily practice, and there is not a strong tradition of scientific research in long-term care. The result is that older people and their families, health care professionals, policy makers, and educators do not benefit sufficiently from new advancements and best available evidence. In this oral paper a model for a sustainable and successful interdisciplinary collaboration between scientists, care providers, and educators in long-term care will be presented: the “Living Lab in Ageing and Long-Term Care” by Maastricht University in the Netherlands. It is a structural collaboration between academia, educational institutions, long-term care providers and clients. It covers approximately 185 long-term care facilities (e.g. nursing homes, assisted and group living facilities) as well as professional home care, and includes about 50,000 clients and more than 27,000 staff. Their mission is to contribute with scientific research to improving i) quality of life of older people and their families; ii) quality of care and iii) quality of work of those working in long-term care. Key working mechanisms are the Linking Pins and interdisciplinary partnership using a team science approach, with great scientific and societal impact. For 25 years this structural collaboration has served as an infrastructure that drives scientific research in long-term care in co-creation with end-users, including older people and their relatives, health care professionals, policy makers and educators. More recently, the model of the living lab is replicated in other countries such as the UK, Belgium, Germany and Austria. After a brief description of the living lab, the collaboration between academia, educational institutions, long-term care providers and clients will be illustrated by introducing the “Stay Active at Home” study. In this study a reablement training programme for home care staff is developed, evaluated and implemented. The programme aims to teach home care staff how to stimulate clients’ autonomy and participation in meaningful daily activities. Finally, the symposium will end with suggestions how to replicate the model of the Living Lab in Ageing and Long-term Care in other places.
June 2023
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21 Reads
Geron
In Nederland zijn veel online wijkplatformen beschikbaar. Deze platformen beogen ouderen te ondersteunen in hun maatschappelijke participatie, waardoor zij langer thuis kunnen blijven wonen. Maar in hoeverre worden deze platformen daadwerkelijk gebruikt door thuiswonende ouderen? En bereiken deze platformen in de praktijk wel hun doelen? Online wijkplatformen In Nederland zijn verschillende online wijkplatformen beschikbaar, zoals MijnBuurtje, WijkConnect en Gebiedonline. Zij hebben meerdere doelen, zoals het ondersteunen van lokale participatie en het stimuleren en faciliteren van informele burenhulp. Via een online platform kunnen wijkbewoners, zo ook thuiswonende ouderen, verschillende applicaties raadplegen. Een aantal voorbeelden daarvan zijn: een tool voor de uitwisseling van informele hulp, vaak 'vraag en aanbod' of 'elkaar helpen' genoemd, en een agenda waar informatie te vinden is over lokale evenementen en activiteiten, zoals een koffie-uurtje of wandelgroep. Wijkplatformen worden door verschillende partijen geïnitieerd en geïmplementeerd, zoals door gemeenten, zorg-en welzijnsorganisaties, ondernemers of wijkbewoners. Naast dat initiatiefnemers verschillen, is er ook variatie in de software van online wijkplatformen en de gehanteerde implementatiestrategieën. Soms worden platformen top-down geïmplementeerd, waarbij het initiatief wordt genomen vanuit een professionele of gemeentelijke organisatie, zonder input of inspraak van wijkbewoners. Platformen kunnen ook bottom-up geïnitieerd en ingevoerd worden vanuit wijkbewoners en vrijwilligers. De regie ligt dan bij bewoners, professionele organisaties worden in dat geval vaak later betrokken. Tot slot wordt soms gekozen voor een mixed-methods strategie. Hierbij ligt het initiatief in het professionele veld (een zorg-of welzijnsorganisatie, of gemeente) terwijl de implementatie in nauwe samenwerking met wijkbewoners en vrijwilligers plaatsvindt (Willard e.a. 2020). Ervaringen van thuiswonende ouderen Vanuit Zuyd Hogeschool hebben wij de afgelopen jaren uitgebreid onderzoek gedaan naar de impact van online wijkplatformen en de ervaringen van thuiswonende ouderen We voerden 5 verschillende studies uit, zowel kwalitatief als kwantitatief van aard (Willard, 2021). Bij deze studies werden in totaal 97 thuiswonende ouderen betrokken. De platformen die wij onderzochten werden op twee plaatsen in Limburg (Heerlen en Grubbenvorst) in langdurige projecten gezamenlijk met thuiswonende ouderen en andere wijkbewoners ontwikkeld. Voordat überhaupt werd gestart met de ontwikkeling (en/of implementatie) van online wijkplatformen, werd door ons aan thuiswonende ouderen uit Heerlen en Grubbenvorst gevraagd, of zij daar behoefte aan hadden. Dat bleek het geval. Bovendien voldeden de ontwikkelde platformen aan gebruikerseisen (user interface), zoals vastgesteld in eerder onderzoek. Behoeften-inventarisaties vooraf en substantiële betrokkenheid van thuiswonende ouderen leken weinig effect te hebben op de acceptatie en het gebruik van de wijkplatformen. Uit ons onderzoek bleek dat online wijkplatformen nauwelijks werden gebruikt. Daarnaast konden wij op basis van een kwantitatieve observationele studie (Willard, et al.2020) vrijwel geen impact vaststellen: online wijkplatformen leken de lokale participatie van thuiswonende ouderen niet te beïnvloeden en daarmee dus ook niet het langer zelfstandig thuiswonen van ouderen te bevorderen.
April 2023
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68 Reads
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1 Citation
Background/objectives: Moving into a nursing home is often an unavoidable life event for older people living with dementia. It is associated with negative emotions and outcomes. Research capturing their perspectives is scarce. This study aims to identify how older people living with dementia perceive a potential life in a nursing home and to understand their (future) care wishes. Materials and methods: This study is part of the European TRANS-SENIOR research network. The study followed a qualitative phenomenological methodology. Semi-structured interviews with 18 community-dwelling older people living with dementia were conducted between August 2018 and October 2019 (METCZ20180085). A stepwise interpretive phenomenological analysis was performed. Results: The majority of community-dwelling older people feared the idea of potentially moving to a nursing home. The participants associated a possible move with negative perceptions and emotions. Additionally, this study emphasized the importance of knowledge of current and past experiences with care when identifying the participant's wishes. They wanted to remain (a) individuals, who are (b) autonomous and have (c) social contacts if they would move to a nursing home. Discussion/implications: This study showed how past and current care experiences can educate/inform healthcare professionals on the future care wishes of older people living with dementia. The results indicated that listening to the wishes, and life stories of people living with dementia could be a way of identifying 'a suitable time' to suggest a move to a nursing home. This could improve the transitional care process and adjustment to living in a nursing home.
February 2023
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123 Reads
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12 Citations
BMC Health Services Research
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 understanding of the facilitators that contribute to developing such a culture. This scoping review aims to identify those facilitators. Methods A scoping review was performed in accordance with the JBI Manual for Evidence Synthesis (2020). The search was carried out in 2020–2021 in seven international databases (PubMed, Cochrane Library, CINAHL, Medline, Embase, PsycINFO and Web of Science). Two researchers independently extracted reported facilitators that contribute to an interprofessional learning culture in nursing homes. Then the researchers inductively clustered the extracted facilitators into categories. Results In total, 5,747 studies were identified. After removing duplicates and screening titles, abstracts and full texts, 13 studies that matched the inclusion criteria were included in this scoping review. We identified 40 facilitators and clustered them into eight categories: (1) shared language, (2) shared goals, (3) clear tasks and responsibilities, (4) learning and sharing knowledge, (5) work approaches, (6) facilitating and supporting change and creativity by the frontline manager, (7) an open attitude, and (8) a safe, respectful and transparent environment. Conclusion We found facilitators that could be used to discuss the current interprofessional learning culture in nursing homes and identify where improvements are required. Further research is needed to discover how to operationalise facilitators that develop an interprofessional learning culture in nursing homes and to gain insights into what works, for whom, to what extent and in what context.
December 2022
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43 Reads
Innovation in Aging
Providing high quality of care can be challenging for nursing staff because of the continuous changes in healthcare. Nursing staff needs to learn continuously to remain employable and deal with these challenges. Therefore, availability of a continuous learning and improvement tool (LINC tool) using nursing quality data and an improvement cycle to maintain high quality of care in long-term care is important. The development of this tool took place in co-creation with researchers, experts, educational staff and nursing staff working in long-term care. Taskforces with researchers and experts on quality data and education were established to develop the main steps of the tool. Nursing staff was involved in the development and testing of the tool. The LINC tool consists of 1) Assessment of the current learning climate and preferred quality data for nursing staff to work with, 2) Discussing findings from step 1 with the nursing staff team and formulate learning topics, 3) Start improvement cycle (PDCA cycle) using one learning climate topic and one quality data topic as a case to improve quality of care and improve the learning climate. During this cycle, nurse coaches are available to help nursing staff use the LINC tool materials. The LINC tool can be used to improve long-term care and has proven to be feasible. However, the LINC tool is currently tested in more nursing staff teams to increase its usability and effectiveness. Further development of the LINC tool is therefore a constant cycle of developing, implementing, testing, and evaluating, all in cooperation with stakeholders.
December 2022
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31 Reads
Innovation in Aging
Healthcare professionals in nursing homes need to be able to keep up with changes at work, deal with a growing complexity in healthcare demands and have to keep developing themselves within a team to be able to plan and deliver high quality of care. To keep up with these changes and demands, an interprofessional learning culture must be stimulated. Insight about developing such a culture in nursing homes is lacking. A scoping review was performed. Articles were examined on actions that positively influence the development of an interprofessional learning culture. 51 Actions were identified. The influencing factors were divided in eight main themes i.e. (1) communication, (2) shared goals, (3) tasks and responsibilities, (4) learning and knowledge, (5) work approaches, (6) attitude, (7) leadership, and (8) safety, respect and transparency. These actions form a basis for an interprofessional learning culture but should be operationalized and tailored to practice use.
December 2022
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40 Reads
Innovation in Aging
To deal with challenges in practice such as workload and complexity in long-term care delivery, learning in practice (workplace learning) is becoming increasingly important. Nursing staff needs to take the lead and learn continuously in practice using a bottom up approach to promote workplace learning. Therefore, insight in workplace learning conditions (like work culture and learning climate) in long-term care is necessary. Based on these insights, nurses can define challenges and goals on how to stimulate workplace learning. Currently, no instruments are available that measure these conditions in the long-term nursing care setting in a snap shot. Therefore, the goal of this study was to develop a quick-scan to measure workplace learning conditions for nursing staff in long-term geriatric care. This quick-scan was developed in 3 steps: (1) investigating how to measure conditions for workplace learning, (2) selecting appropriate measurement tools to measure conditions for workplace learning, and (3) testing the feasibility of the quick-scan in practice. As a result, the final feasible quick-scan measured 11 conditions regarding workplace learning: (1) Trust: values and culture, (2) Team: support and management, (3) Colleagues: support and respect, (4) Constraints in undertaking the job, (5) Urgency, (6) Learner agency, (7) Collaboration, (8) Hybrid learning, (9) Coaching, (10) Flexibility – formal and informal learning, and (11) Assessment-as-learning. Additionally, questions were added regarding availability of sources for learning, knowledge and skills, and communication. Validated questionnaires that were included were the Culture of Care Barometer and HILL model questionnaire.
... Dutch longterm care is largely funded through mandatory public health insurance and is increasingly focusing on personcentered care, integrating technology (e.g., eHealth, telecare), and promoting self-management to enhance the quality of life [2]. Complex care demands, nursing staff shortages, and scarcity of resources [3] demand more than ever that long-term care organizations are prepared for innovation to ensure affordable access to care for older adults [4][5][6][7][8]. Greenhalgh et al. [9] see innovation as "a novel set of behaviors, routines, and ways of working that are discontinuous with previous practice, are directed at improving health outcomes, administrative efficiency, cost-effectiveness, or user experience and that are implemented by planned and coordinated actions. ...
February 2023
BMC Health Services Research
... 3 However, strategies that involve sending a few professionals to classroom-based training or bringing trainers into the workplace to provide didactic courses are less effective within the complex environment of the NH, especially given its human resource shortage and high staff turnover rate. 15,16 The learning benefits only a few professionals who attended the training, and the transfer of acquired knowledge into the workplace to advance organisational outcomes is challenging. 17 Moreover, traditional learning strategies ineffectively support interprofessional collaborative learning for diverse occupational groups with differing educational needs across groups. ...
August 2022
BMC Nursing
... Professionals struggle to understand why informal caregivers do not seek respite care despite a clear need or tend to delay seeking help until it is almost too late (O'Shea et al., 2017). The reasons can be attributed to a combination of factors including informal caregivers' lack of knowledge, difficulty navigating the healthcare system (Bragstad et al., 2014), lack of trust in formal health care services (Groenvynck et al., 2022) and the emotional and physical demands of caregiving (Groenvynck et al., 2022;Roberts & Struckmeyer, 2018). ...
March 2022
Age and Ageing
... The frequency of weekly supervision may also have been a relevant factor in enabling the review and goal adjustments. A study conducted with formal caregivers of older people with dementia in-home care (Rooijackers et al., 2021), with an average frequency of meetings every two months, did not identify effects in reducing SB. No conclusive results on interventions mediated by caregivers were identified among the institutionalized population. ...
December 2021
... Randomized controlled trials 22 [41,42,73,79,85,92,94,100,102,130,131,141,145,147,148,[155][156][157]164,178,180,189] Cross-sectional studies 16 [11,26,34,40,81,91,112,133,136,139,146,150,159,181,197,198] Clinical controlled trials 11 [45,52,74,95,96,114,128,151,169,175,176] Cohort studies 13 [19,29,55,98,101,103,106,113,129,167,171,182,186] Feasibility/methodology studies 3 [179,188,199] Intervention studies with one group pre-post test designs 15 [43,44,46,65,70,87,144,152,153,[183][184][185]194,196] Case reports 7 [25,54,67,68,80,160] Qualitative studies n=54 ...
January 2022
Geriatric Nursing
... Our findings on frailty identification are consistent with those reported by previous studies [10,12,25,26]. However, Warnier et al. showed that frailty screening forms part of nurses' duties in two hospitals in the Netherlands, e.g., via pain assessments; therefore, these discrepancies in findings may have resulted from differences in study context, design, and setting [27]. The number of oncology nurses that implemented FC behaviors was small, which was possibly related to their nursing grades, willingness to receive frailty-related training, experience of nursing frail patients, frailty-related knowledge learning experience, and frailty-related training experience; these findings are in line with those of a previous study [28]. ...
November 2021
BMC Geriatrics
... 32,46,51 An alignment between the innovation and the organizational culture or vision appeared to support the implementation process. 38,48,51, 61,62,68,76,103,109,116,117,125,126 Demonstrating alignment between the organization's vision and innovation also helped alleviate stakeholders' concerns about its future direction, enhancing motivation to engage with the innovation. 32,38,62 However, when they were not aligned, participants reported that a change in or even a decision not to implement the innovation was needed. ...
July 2021
BMC Nursing
... educ and mfar (w/med) (1800) educ and mfar (w/med+slfm) (172) educ and rsk-mfa-(258) educ and rsk-mfa-(308) eng and educ (95) eng and educ (96) educ and psyc (23) exrc and psyc (23) cgn and med and ntr and exrc (170) ADL and ntr and exrc (144) med and ntr and exrc (85) med and ntr and exrc (85) ntr and exrc (61) ADL (141) ADL (141) ADL and aids and educ and exrc and mfar (w/med+slfm) (130) ADL and aids and educ and exrc and mfar (w/med+slfm) (130) educ and exrc and mfar (w/med+slfm) (100) educ and mfar (w/med+slfm) (172) exrc and mfar (w/med+slfm) (120) mfar (w/med+slfm) (130) educ and mfar (w/med) (1523) educ and rsk-mfa-(217) ADL and aids and exrc (149) cgn and ntr and exrc (46) ADL and med and ntr and sst (139) aids ( (374) hmcr and ADL and mfar (w/slfm) (174) hmcr and ADL and mfar (w/slfm) (133) hmcr and mfa- (45) hmcr and mfar (w/med) (99) hmcr and hmnt and exrc (29) mntr-mfa- (102) exrc and mfar (w/med+slfm) (106) mfa-(w/med) (50) mfa-(w/med) (75) mfa-(w/med) (120) mfa- (147) hmcr and mfar (w/s m) (81) mfar (w/med) ...
June 2021
Journal of the American Geriatrics Society
... This review highlighted five definite roles nurses play in the implementation of best practices: leadership, collaboration, education and training, communication and feedback and development and tailoring of the best practice. The importance of the leadership role nurses play in this regard was also discussed elsewhere (Bianchi et al. 2018;Vogel et al. 2021). In this review, multiple sub-roles in the nurses' leadership role in the implementation of best evidence were identified, including recruitment, developing the educational intervention and data analysis. ...
April 2021
... Concerning the person-centredness approach in transitional care, the need for a personalised approach resembles the person-centredness approach addressed in the transitional care model (Hirschman et al. 2015), which suggests that professionals adopt a holistic and person-centred approach and that relationships with older people and their informal caregivers must be maintained. Also, our findings regarding personcentredness resemble Groenvynck et al.'s scoping review on interventions to improve the transition from home to a nursing home (Groenvynck et al. 2022). However, in their scoping review, Groenvynck et al. reported that most person-centred interventions failed to report how they tailored their intervention. ...
March 2021
The Gerontologist