Background Providing individualized care based on the context and preferences of the patient is important. Knowledge on both prognostic risk stratification and blended eHealth care in musculoskeletal conditions is increasing and seems promising. Stratification can be used to match patients to the most optimal content and intensity of treatment as well as mode of treatment delivery (i.e. face-to-face or blended with eHealth). However, research on the integration of stratified and blended eHealth care with corresponding matched treatment options for patients with neck and/or shoulder complaints is lacking. Methods This study was a mixed methods study comprising the development of matched treatment options, followed by an evaluation of the feasibility of the developed Stratified Blended Physiotherapy approach. In the first phase, three focus groups with physiotherapists and physiotherapy experts were conducted. The second phase investigated the feasibility (i.e. satisfaction, usability and experiences) of the Stratified Blended Physiotherapy approach for both physiotherapists and patients in a multicenter single-arm convergent parallel mixed methods feasibility study. Results In the first phase, matched treatment options were developed for six patient subgroups. Recommendations for content and intensity of physiotherapy were matched to the patient’s risk of persistent disabling pain (using the Keele STarT MSK Tool: low/medium/high risk). In addition, selection of mode of treatment delivery was matched to the patient’s suitability for blended care (using the Dutch Blended Physiotherapy Checklist: yes/no). A paperbased workbook and e-Exercise app modules were developed as two different mode of treatment delivery options, to support physiotherapists. Feasibility was evaluated in the second phase. Physiotherapists and patients were mildly satisfied with the new approach. Usability of the physiotherapist dashboard to set up the e-Exercise app was considered ‘OK’ by physiotherapists. Patients considered the e-Exercise app to be of ‘best imaginable’ usability. The paper-based workbook was not used. Conclusion Results of the focus groups led to the development of matched treatment options. Results of the feasibility study showed experiences with integrating stratified and blended eHealth care and have informed amendments to the Stratified Blended Physiotherapy approach for patients with neck and/or shoulder complaints ready to use within a future cluster randomized trial.
Background Providing individualized care based on the context and preferences of the patient is important. Knowledge on both prognostic risk stratification and blended eHealth care in musculoskeletal conditions is increasing and seems promising. Stratification can be used to match patients to the most optimal content and intensity of treatment as well as mode of treatment delivery (i.e. face-to-face or blended with eHealth). However, research on the integration of stratified and blended eHealth care with corresponding matched treatment options for patients with neck and/or shoulder complaints is lacking. Methods This study was a mixed methods study comprising the development of matched treatment options, followed by an evaluation of the feasibility of the developed Stratified Blended Physiotherapy approach. In the first phase, three focus groups with physiotherapists and physiotherapy experts were conducted. The second phase investigated the feasibility (i.e. satisfaction, usability and experiences) of the Stratified Blended Physiotherapy approach for both physiotherapists and patients in a multicenter single-arm convergent parallel mixed methods feasibility study. Results In the first phase, matched treatment options were developed for six patient subgroups. Recommendations for content and intensity of physiotherapy were matched to the patient’s risk of persistent disabling pain (using the Keele STarT MSK Tool: low/medium/high risk). In addition, selection of mode of treatment delivery was matched to the patient’s suitability for blended care (using the Dutch Blended Physiotherapy Checklist: yes/no). A paperbased workbook and e-Exercise app modules were developed as two different mode of treatment delivery options, to support physiotherapists. Feasibility was evaluated in the second phase. Physiotherapists and patients were mildly satisfied with the new approach. Usability of the physiotherapist dashboard to set up the e-Exercise app was considered ‘OK’ by physiotherapists. Patients considered the e-Exercise app to be of ‘best imaginable’ usability. The paper-based workbook was not used. Conclusion Results of the focus groups led to the development of matched treatment options. Results of the feasibility study showed experiences with integrating stratified and blended eHealth care and have informed amendments to the Stratified Blended Physiotherapy approach for patients with neck and/or shoulder complaints ready to use within a future cluster randomized trial.
Purpose Worry is an intuitive sense that goes beyond logical reasoning and is valuable in situations where patients’ conditions are rapidly changing or when objective data may not fully capture the complexity of a patient’s situation. Nurse anesthetists’ subjective reasons for worry are quite vague as they are valued inconsistently and not accurately expressed. This study aimed to identify factors playing a role in the emergence of worry during anesthesia practice to clarify its concept. Design Mixed-methods design consisting of quantitative online surveys followed by qualitative focus group interviews including Dutch nurse anesthetists. Methods Both quantitative and qualitative thematic analyses were performed, followed by data and methodological triangulation to enhance the validity and credibility of findings and mitigate the presence of bias. Findings Surveys (N = 102) were analyzed, and 14 nurse anesthetists participated in the focus group interviews. A total of 89% of the survey respondents reported that at least once have had the feeling of worry, of which 92% use worry during clinical anesthesia practice. Worry was mentioned to be a vital element during anesthesia practice that makes it possible to take precautionary actions to change the anesthetic care plan in a changing situation or patient deterioration. Conclusions While a clear definition of worry could not be given, it is a valuable element of anesthesia practice as it serves as a catalyst for critical thinking, problem-solving, clinical reasoning, and decision-making. Use of the feeling of worry alongside technological systems to make an informed decision is crucial. Technology has significantly improved the ability of health care providers to detect and respond to patient deterioration promptly, but it is crucial for nurse anesthetists to use their feeling of worry or intuition alongside technological systems and evidence-based practice to ensure quick assessments or judgments based on experience, knowledge, and observations in clinical practice.
LINK
Vanuit het werkveld bereiken Fontys Sporthogeschool (FSH) regelmatig vragen voor effectievere ondersteuning bij docentprofessionalisering van docenten Lichamelijke Opvoeding (LO). Deze zijn geconcretiseerd naar enkele breed gedeelde praktijk-vraagstellingen. Een innovatieve en veelbelovende methode voor docentprofessionalisering is Lesson Study (LS). Bij LS werken docenten samen aan het ontwerpen, uitvoeren en onderzoeken van een les. Deze aanpak voldoet aan kenmerken voor effectieve docentprofessionalisering zoals omschreven in de wetenschappelijke literatuur. Het is echter nog niet bekend of LS daadwerkelijk effectief is. Het consortium bestaande uit FSH, Universiteit Gent, Universiteit Utrecht, en de Academische Opleidingsscholen West-Brabant, Brabant Noord-Oost, Tilburg en Den Bosch, is daarom gekomen tot de volgende onderzoeksvragen: 1) Wat zijn de effecten van een workshop ‘motivationeel klimaat’ gevolgd door een begeleide lesson study op de vijf niveaus van doorwerking van Guskey (2000), in vergelijking met alleen een workshop? 2) Welke belemmeringen en succesfactoren kunnen er geïdentificeerd worden met betrekking tot het zelfstandig toepassen van de methode lesson study door docenten LO? 3) Hoe waarderen docenten LO en hun leidinggevenden de opbrengsten van de methode lesson study ten opzichte van de tijdsinvestering die deze vergt? In het onderzoek is sprake van een mixed-methods aanpak. De effecten (vraag 1) worden kwantitatief gemeten aan de hand van de niveaus van Guskey (2000) en vergeleken met een controlegroep van scholen die alleen een workshop krijgen. Vraag 2 en 3 worden kwalitatief onderzocht via focusgroepgesprekken (docenten) en semi-gestructureerde interviews (leidinggevenden). De opbrengsten van dit project zijn kennis met betrekking tot de effectiviteit en bruikbaarheid van LS voor docentprofessionalisering bij LO. Deze kennis wordt verspreid met nationale en internationale publicaties en presentaties. Voor het werkveld wordt tevens een symposium georganiseerd. De kennis zal niet alleen indalen in de lerarenopleiding LO van Fontys Sporthogeschool, maar LS zal bij gebleken effectiviteit ook in worden gezet als werkvorm voor LO-studenten die stagelopen.
