Despite the increased use of activity trackers, little is known about how they can be used in healthcare settings. This study aimed to support healthcare professionals and patients with embedding an activity tracker in the daily clinical practice of a specialized mental healthcare center and gaining knowledge about the implementation process. An action research design was used to let healthcare professionals and patients learn about how and when they can use an activity tracker. Data collection was performed in the specialized center with audio recordings of conversations during therapy, reflection sessions with the therapists, and semi-structured interviews with the patients. Analyses were performed by directed content analyses. Twenty-eight conversations during therapy, four reflection sessions, and eleven interviews were recorded. Both healthcare professionals and patients were positive about the use of activity trackers and experienced it as an added value. Therapists formulated exclusion criteria for patients, a flowchart on when to use the activity tracker, defined goals, and guidance on how to discuss (the data of) the activity tracker. The action research approach was helpful to allow therapists to learn and reflect with each other and embed the activity trackers into their clinical practice at a specialized mental healthcare center.
This dissertation describes a research project about the communication between communication vulnerable people and health care professionals in long-term care settings. Communication vulnerable people experience functional communication difficulties in particular situations, due to medical conditions. They experience difficulties expressing themselves or understanding professionals, and/or professionals experience difficulties understanding these clients. Dialogue conversations between clients and professionals in healthcare, which for example concern health-related goals, activity and participation choices, diagnostics, treatment options, and treatment evaluation, are, however, crucial for successful client-centred care and shared decision making. Dialogue conversations facilitate essential exchanges between clients and healthcare professionals, and both clients and professionals should play a significant role in the conversation. It is unknown how communication vulnerable people and their healthcare professionals experience dialogue conversations and what can be done to support successful communication in these conversations. The aim of this research is to explore how communication vulnerable clients and professionals experience their communication in dialogue conversations in long-term care and how they can best be supported in improving their communication in these conversations.
Objective: Effective healthcare innovations are often not adopted and implemented. An implementation strategy based on facilitators and barriers for use as perceived by healthcare professionals could increase adoption rates. This study therefore aimed to identify the most relevant facilitators and barriers for use of an innovative breast cancer aftercare decision aid (PtDA) in healthcare practice. Methods: Facilitators and barriers (related to the PtDA, adopter and healthcare organisation) were assessed among breast cancer aftercare health professionals (n = 81), using the MIDI questionnaire. For each category, a backward regression analysis was performed (dependent = intention to adopt). All significant factors were then added to a final regression analysis to identify to most relevant determinants of PtDA adoption. Results: Expecting higher compatibility with daily practice and clinical guidelines, more positive outcomes of use, higher perceived relevance for the patient and increased self-efficacy were significantly associated with a higher intention to adopt. Self-efficacy and perceived patient relevance remained significant in the final model. Conclusions: Low perceived self-efficacy and patient relevance are the most important barriers for health professions to adopt a breast cancer aftercare PtDA. Practice implications: To target self-efficacy and perceived patient relevance, the implementation strategy could apply health professional peer champions.
Everyone has the right to participate in society to the best of their ability. This right also applies to people with a visual impairment, in combination with a severe or profound intellectual and possibly motor disability (VISPIMD). However, due to their limitations, for their participation these people are often highly dependent on those around them, such as family members andhealthcare professionals. They determine how people with VISPIMD participate and to what extent. To optimize this support, they must have a good understanding of what people with disabilities can still do with their remaining vision.It is currently difficult to gain insight into the visual abilities of people with disabilities, especially those with VISPIMD. As a professional said, "Everything we can think of or develop to assess the functional vision of this vulnerable group will help improve our understanding and thus our ability to support them. Now, we are more or less guessing about what they can see.Moreover, what little we know about their vision is hard to communicate to other professionals”. Therefore, there is a need for methods that can provide insight into the functional vision of people with VISPIMD, in order to predict their options in daily life situations. This is crucial knowledge to ensure that these people can participate in society to their fullest extent.What makes it so difficult to get this insight at the moment? Visual impairments can be caused by a range of eye or brain disorders and can manifest in various ways. While we understand fairly well how low vision affects a person's abilities on relatively simple visual tasks, it is much more difficult to predict this in more complex dynamic everyday situations such asfinding your way or moving around during daily activities. This is because, among other things, conventional ophthalmic tests provide little information about what people can do with their remaining vision in everyday life (i.e., their functional vision).An additional problem in assessing vision in people with intellectual disabilities is that many conventional tests are difficult to perform or are too fatiguing, resulting in either no or the wrong information. In addition to their visual impairment, there is also a very serious intellectual disability (possibly combined with a motor impairment), which makes it even more complex to assesstheir functional vision. Due to the interplay between their visual, intellectual, and motor disabilities, it is almost impossible to determine whether persons are unable to perform an activity because they do not see it, do not notice it, do not understand it, cannot communicate about it, or are not able to move their head towards the stimulus due to motor disabilities.Although an expert professional can make a reasonable estimate of the functional possibilities through long-term and careful observation, the time and correct measurement data are usually lacking to find out the required information. So far, it is insufficiently clear what people with VZEVMB provoke to see and what they see exactly.Our goal with this project is to improve the understanding of the visual capabilities of people with VISPIMD. This then makes it possible to also improve the support for participation of the target group. We want to achieve this goal by developing and, in pilot form, testing a new combination of measurement and analysis methods - primarily based on eye movement registration -to determine the functional vision of people with VISPIMD. Our goal is to systematically determine what someone is responding to (“what”), where it may be (“where”), and how much time that response will take (“when”). When developing methods, we take the possibilities and preferences of the person in question as a starting point in relation to the technological possibilities.Because existing technological methods were originally developed for a different purpose, this partly requires adaptation to the possibilities of the target group.The concrete end product of our pilot will be a manual with an overview of available technological methods (as well as the methods themselves) for assessing functional vision, linked to the specific characteristics of the target group in the cognitive, motor area: 'Given that a client has this (estimated) combination of limitations (cognitive, motor and attention, time in whichsomeone can concentrate), the order of assessments is as follows:' followed by a description of the methods. We will also report on our findings in a workshop for professionals, a Dutch-language article and at least two scientific articles. This project is executed in the line: “I am seen; with all my strengths and limitations”. During the project, we closely collaborate with relevant stakeholders, i.e. the professionals with specific expertise working with the target group, family members of the persons with VISPIMD, and persons experiencing a visual impairment (‘experience experts’).
Wat dragen creatieve onderzoeksmethodes bij aan vernieuwing binnen de zorg? We onderzoeken dit binnen tien projecten van het Create Health-programma van ZonMw. In deze projecten wordt kennis ontwikkeld over de toegevoegde waarde van creatieve manieren van werken bij e-health innovatie. Informatie over de onderzoeksresultaten is te vinden op de website: husite.nl/creatieve-onderzoeksmethodes en het artikel: CHIWaWA maakt samenwerking in create-health onderzoek inzichtelijk | Hogeschool Utrecht (hu.nl)Doel Het Create Health programma heeft tot doel om bij te dragen aan maatschappelijke uitdagingen rondom gezond en actief ouder worden. CHIWaWA werkt daarbij toe naar een conceptueel model dat manieren van werken in kaart brengt in create health projecten – gekoppeld aan theorie over boundary crossing en research impact – met betrekking tot projectuitkomsten en kennis-, persoonlijke-, en systeemontwikkeling van betrokken actoren. Resultaten onderzoek Kennis die zowel online als offline te raadplegen is, in een boek, in wetenschappelijke artikelen en op een website. Deze kennis bevat: Inzicht in kansen om impact van e-health innovatie in ‘create health’-samenwerking te vergroten; Projectnarratieven met ‘best practices’ voor interdisciplinaire samenwerking waarbij onderzoekers, creatieve industrie en zorgprofessionals betrokken zijn; Guidelines voor ontwikkelaars van e-health applicaties m.b.t. samenwerking met de creatieve industrie; Guidelines voor beleidsmakers m.b.t. het stimuleren van samenwerking tussen zorg en creatieve industrie en het gebruik van creatieve manieren van werken om onderzoek naar de praktijk te krijgen; Aanpak Vanuit een service-dominant logic perspectief wordt bekeken hoe toegepaste kennis en skills worden gedeeld tussen actoren die betrokken zijn bij de verschillende ‘create health’-projecten, wat de meerwaarde daarvan is en wat actoren van die uitwisseling – als proces – leren. De focus ligt op co-creatie van waarde, die door samenwerking en uitwisseling tot stand komt. Door middel van procesonderzoek wordt er toegewerkt naar bijdragen aan theorieontwikkeling op het gebied van boundary crossing en contribution mapping. Resultaten Eindpublicatie: Create Health: Samenwerking tussen zorg, wetenschap en creatieve industrie (2023) Boek: Create Ways of Working. Insights from ten ehealth Innovation research projects (2022) Website www.creatieveonderzoeksmethodes.nl (2022) Bijdragen aan conferenties en symposia Co-design in de anderhalvemetermaatschappij (whitepaper), Dutch Design Week 2020. Download de presentatieslides. Collaborating in complexity. Strategies for interdisciplinary collaboration n design work, Design4Health conference 2020 Grounding Practices. How researchers ground their work in create-health collaborations for designing e-health solutions, Design4Health conference 2020 Seven ways to foster interdisciplinary collaboration in research involving healthcare and creative research disciplines, DementiaLab conference 2019 Posterpresentatie: Health x Design, DementiaLab conference 2019 Meer informatie over het Create Health programma Het ZonMw programma Create Health heeft als doel om bij te dragen aan de maatschappelijke uitdaging rondom gezond en actief ouder worden. Binnen het programma worden activiteiten uitgezet waarbij de samenwerking tussen de creatieve industrie en zorg en welzijn voorop staat. Het gaat hierbij om publiek-private samenwerking (PPS).
Wat dragen creatieve onderzoeksmethodes bij aan vernieuwing binnen de zorg? We onderzoeken dit binnen tien projecten van het Create Health-programma van ZonMw. In deze projecten wordt kennis ontwikkeld over de toegevoegde waarde van creatieve manieren van werken bij e-health innovatie. Informatie over de onderzoeksresultaten is te vinden op de website: husite.nl/creatieve-onderzoeksmethodes en het artikel: CHIWaWA maakt samenwerking in create-health onderzoek inzichtelijk | Hogeschool Utrecht (hu.nl)Doel Het Create Health programma heeft tot doel om bij te dragen aan maatschappelijke uitdagingen rondom gezond en actief ouder worden. CHIWaWA werkt daarbij toe naar een conceptueel model dat manieren van werken in kaart brengt in create health projecten – gekoppeld aan theorie over boundary crossing en research impact – met betrekking tot projectuitkomsten en kennis-, persoonlijke-, en systeemontwikkeling van betrokken actoren. Resultaten onderzoek Kennis die zowel online als offline te raadplegen is, in een boek, in wetenschappelijke artikelen en op een website. Deze kennis bevat: Inzicht in kansen om impact van e-health innovatie in ‘create health’-samenwerking te vergroten; Projectnarratieven met ‘best practices’ voor interdisciplinaire samenwerking waarbij onderzoekers, creatieve industrie en zorgprofessionals betrokken zijn; Guidelines voor ontwikkelaars van e-health applicaties m.b.t. samenwerking met de creatieve industrie; Guidelines voor beleidsmakers m.b.t. het stimuleren van samenwerking tussen zorg en creatieve industrie en het gebruik van creatieve manieren van werken om onderzoek naar de praktijk te krijgen; Aanpak Vanuit een service-dominant logic perspectief wordt bekeken hoe toegepaste kennis en skills worden gedeeld tussen actoren die betrokken zijn bij de verschillende ‘create health’-projecten, wat de meerwaarde daarvan is en wat actoren van die uitwisseling – als proces – leren. De focus ligt op co-creatie van waarde, die door samenwerking en uitwisseling tot stand komt. Door middel van procesonderzoek wordt er toegewerkt naar bijdragen aan theorieontwikkeling op het gebied van boundary crossing en contribution mapping. Resultaten Eindpublicatie: Create Health: Samenwerking tussen zorg, wetenschap en creatieve industrie (2023) Boek: Create Ways of Working. Insights from ten ehealth Innovation research projects (2022) Website www.creatieveonderzoeksmethodes.nl (2022) Bijdragen aan conferenties en symposia Co-design in de anderhalvemetermaatschappij (whitepaper), Dutch Design Week 2020. Download de presentatieslides. Collaborating in complexity. Strategies for interdisciplinary collaboration n design work, Design4Health conference 2020 Grounding Practices. How researchers ground their work in create-health collaborations for designing e-health solutions, Design4Health conference 2020 Seven ways to foster interdisciplinary collaboration in research involving healthcare and creative research disciplines, DementiaLab conference 2019 Posterpresentatie: Health x Design, DementiaLab conference 2019 Meer informatie over het Create Health programma Het ZonMw programma Create Health heeft als doel om bij te dragen aan de maatschappelijke uitdaging rondom gezond en actief ouder worden. Binnen het programma worden activiteiten uitgezet waarbij de samenwerking tussen de creatieve industrie en zorg en welzijn voorop staat. Het gaat hierbij om publiek-private samenwerking (PPS).
