The use of the biopsychosocial model in primary care physiotherapy for chronic pain is far from the recommendations given in research and current guidelines. To understand why physiotherapists have difficulty implementing a biopsychosocial approach, more insight is needed on the barriers and facilitators. This scoping review aimed to investigate and map these barriers and facilitators that physiotherapists working in primary care reportedly face when treating patients with chronic musculoskeletal pain from a biopsychosocial perspective. Four electronic databases (PubMed, Embase, CINAHL and ERIC) and the grey literature were searched. Studies were included if they investigated the experiences of physiotherapists in the treatment of chronic pain from a biopsychosocial perspective in primary care. Extracted data were discussed and sub grouped in themes following a qualitative content analysis approach. To align with current use of theories on behavior change, the resulting themes were compared to the Theoretical Domains Framework. After screening, twenty-four studies were included. Eight groups of barriers and facilitators were identified, thematically clustered in six themes: knowledge, skills, and attitudes; environmental context and resources; role clarity; confidence; therapeutic alliance; and patient expectations. The results of this review can be used to inform the development of implementation programs.
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PURPOSE: Malnutrition and sarcopenia require dietetic and physiotherapy interventions. In this study, we aimed to compare interprofessional identity of dietitians and physiotherapists, as well as attitudes towards, facilitators and barriers for, and occurrence of interprofessional treatment of malnutrition and sarcopenia by both professions.METHODS: A cross-sectional online survey was distributed from December 4, 2021 until January 31, 2022 through an international online network platform for professionals (LinkedIn). Practitioners working as dietitian or physiotherapist in a healthcare setting were eligible for participation. Outcome measures concerned perceptions regarding shared problem domains, interprofessional treatment, attitudes towards interprofessional treatment, interprofessional identity, facilitators, and barriers. A Chi 2-test, Mann-Whitney U-test, and Spearman's Rho correlation were calculated. RESULTS: Data from 53 physiotherapists and 48 dietitians were included. Malnutrition is considered a shared problem domain by both professions ( U = 1248.000; p = 0.858). While sarcopenia is treated by both professions ( U = 1260.000; p = 0.927), physiotherapists consider sarcopenia more often a shared problem domain compared to dietitians ( U = 1003.000; p = 0.044). Attitudes towards interprofessional treatment were mostly positive (73%, n = 35 and 87%, n = 46 respectively). Interprofessional identity of dietitians was lower compared to physiotherapists (median = 4.0 versus median = 4.3 respectively; U = 875.000, p = 0.007). This was explained by lower interprofessional belonging (median = 4.0 versus median = 4.8 respectively; U = 771.000, p < 0.001) and lower interprofessional commitment (median = 4.0 versus median = 4.3 respectively; U = 942.500, p = 0.023). Interprofessional identity was correlated with efficient means of communication ( r = 0.30, p = 0.003) and bureaucracy ( r = -0.21, p = 0.034). Other barriers reported included available time, financial compensation, interprofessional knowledge, and obtaining extra care. Most reported facilitators concerned role clarity, clarity of expertise, and willingness of others to collaborate. CONCLUSION: Dietitians and physiotherapists have different interprofessional identities, but both are advocates of interprofessional treatment. Both professions mostly treat malnutrition and sarcopenia individually and have different perceptions regarding sarcopenia as shared problem domain. Facilitators were mainly related to clarity and commitment while barriers were mainly related to resources.
from Narcis.nl: "Background: Introducing a post-discharge community pharmacist home visit can secure continuity of care and prevent drug-related problems. Currently, this type of pharmaceutical care is not standard practice and implementation is challenging. Mapping the factors influencing the implementation of this new form of care is crucial to ensure successful embedding. Objective: To explore which barriers and facilitators influence community pharmacists' adoption of a post-discharge home visit. Methods: A mixed methods study was conducted with community pharmacists who had recently participated in a study that evaluated the effectiveness of a post-discharge home visit in identifying drug-related problems. Four focus groups were held guided by a topic guide based on the framework of Greenhalgh et al. After the focus groups, major barriers and facilitators were formulated into statements and presented to all participants in a scoring list to rank for relevance and feasibility in daily practice. Results: Twenty-two of the eligible 26 pharmacists participated in the focus groups. Twenty pharmacists (91%) returned the scoring list containing 21 statements. Most of these statements were perceived as both relevant and feasible by the responding pharmacists. A small number scored high on relevance but low on feasibility, making these potential important barriers to overcome for broad implementation. These were the necessity of dedicated time for performing pharmaceutical care, implementing the home visit in pharmacists' daily routine and an adequate reimbursement fee for the home visit. Conclusions: The key to successful implementation of a post-discharge home visit may lay in two facilitators which are partly interrelated: changing daily routine and reimbursement. Reimbursement will be a strong incentive, but additional efforts will be needed to reprioritize daily routines."
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Teachers have a crucial role in bringing about the extensive social changes that are needed in the building of a sustainable future. In the EduSTA project, we focus on sustainability competences of teachers. We strengthen the European dimension of teacher education via Digital Open Badges as means of performing, acknowledging, documenting, and transferring the competencies as micro-credentials. EduSTA starts by mapping the contextual possibilities and restrictions for transformative learning on sustainability and by operationalising skills. The development of competence-based learning modules and open digital badge-driven pathways will proceed hand in hand and will be realised as learning modules in the partnering Higher Education Institutes and badge applications open for all teachers in Europe.Societal Issue: Teachers’ capabilities to act as active facilitators of change in the ecological transition and to educate citizens and workforce to meet the future challenges is key to a profound transformation in the green transition.Teachers’ sustainability competences have been researched widely, but a gap remains between research and the teachers’ practise. There is a need to operationalise sustainability competences: to describe direct links with everyday tasks, such as curriculum development, pedagogical design, and assessment. This need calls for an urgent operationalisation of educators’ sustainability competences – to support the goals with sustainability actions and to transfer this understanding to their students.Benefit to society: EduSTA builds a community, “Academy of Educators for Sustainable Future”, and creates open digital badge-driven learning pathways for teachers’ sustainability competences supported by multimodal learning modules. The aim is to achieve close cooperation with training schools to actively engage in-service teachers.Our consortium is a catalyst for leading and empowering profound change in the present and for the future to educate teachers ready to meet the challenges and act as active change agents for sustainable future. Emphasizing teachers’ essential role as a part of the green transition also adds to the attractiveness of teachers’ work.
Om de ambities te behalen zoals geformuleerd in de Sustainable Development Goals, is transdisciplinaire samenwerking nodig tussen overheden, bedrijfsleven, burgers en wetenschap. Dit vraagt om multi-stakeholderbenaderingen waarin leren van en met elkaar centraal staat. Dit onderzoeksvoorstel is een vertaalslag van bovenstaande ambitie zoals geformuleerd in samenwerking met hoger onderwijs partners in Bandung, Indonesië. Het Living Lab Upper Citarum biedt een context om onderzoek te doen binnen een bestaand Living Lab gekenmerkt door de multi-stakeholder setting en de complexiteit van duurzaam beheer van natuurlijke hulpbronnen. Het onderzoek beoogt inzicht te verkrijgen in essentiële ‘21st century skills’ voor deelnemers met faciliterende rollen in een Living Lab. De onderzoeksstrategie wil een bijdrage leveren aan de duurzaamheidsagenda van Living Labs met het ontwerpen, het ervaren, reflecteren en documenteren van praktische interventies in de lokale context. De keuze voor werken op locatie is een eerste benadering in het creëren van een realistische leerervaring voor Living Lab facilitators met diverse achtergronden en valt daarmee te beschrijven als ‘learning by doing’. De algemene onderzoekvraag is als volgt geformuleerd: Which contemporary skills and capabilities are present and which need to be developed to establish a widely shared mind set for trans- or interdisciplinary strategies so that communities and institutions in a Living Lab configuration increase their performance? De onderzoeksstrategie krijgt vorm in een ‘21st century skills exploration’ die een experimentele leerruimte biedt aan medewerkers van diverse instituten en (overheids-)organisaties die actief zijn in het Living Lab om kennis te maken met de creatieve methodes voor publieke participatie. Dit vindt vooral plaats in interactie met lokale gemeenschappen met nadruk op creatieve methodes zoals een poetry route, participatory mapping en film. Na presentatie op locatie worden de resultaten gepresenteerd tijdens een mini-symposium in Bandung.
In line with the ‘Natuur- en milieubeleidsplan Caribisch Nederland 2020-2030 (NMBP)’ the consortium intends with this research proposal to contribute to a prosperous society with a resilient population and healthy natural environment. The Caribbean Netherlands are dealing with a situation where imported vegetables and fruits are mostly imported and hardly affordable. This leads to consuming unhealthy food and high obesities rates as a consequence. A lack of good agricultural practices with regard to water-smart and nature inclusive agriculture, as well as limited coping capacities to deal with hazards and climate change, results in very limited local production and interest. Initiatives that focused only on agrotechnological solutions for food resilient futures turned out to be ineffective due to a lack of local ownership, which jeopardizes sustainability. Moreover, the ‘green’ and ‘blue’ domains are not seen as attractive career perspectives among youth, hampering a bright future for those domains. The aim of this research is to contribute to water-smart and nature inclusive food resilience embedded in a local participatory perspective in the Caribbean Netherlands. To address the above challenges, a living lab approach is adopted, where youth will be trained as (co)-facilitators (WP1) who will contribute to a participatory envisioning process and an articulation of food resilient futures (WP2). Finally, based on the envisioning process local stakeholders will select and implement experiments for food resilient futures followed by dissemination of results among key stakeholders as well as children and youth at the BES islands (WP3). This project strategy will lead to a network of a living lab where professionals and youth work together on food resilient futures. Training manuals and the results of experiments with regard to water and food system alternatives will be used actively to encourage youth to be involved in sustainable agriculture and consumption.
