Background: Osteoarthritis is a major public health concern. Despite existing evidence-based treatment options, the health care situation remains unsatisfactory. Digital care options, especially when combined with in-person sessions, seem to be promising. Objective: The aim of this study was to investigate the needs, preconditions, barriers, and facilitators of blended physical therapy for osteoarthritis. Methods: This Delphi study consisted of interviews, an online questionnaire, and focus groups. Participants were physical therapists, patients with hip and/or knee osteoarthritis with or without experience in digital care, and stakeholders of the health care system. In the first phase, interviews were conducted with patients and physical therapists. The interview guide was based on the Consolidated Framework For Implementation Research. The interviews focused on experiences with digital and blended care. Furthermore, needs, facilitators, and barriers were discussed. In the second phase, an online questionnaire and focus groups served the process to confirm the needs and collect preconditions. The online questionnaire contained statements drawn by the results of the interviews. Patients and physical therapists were invited to complete the questionnaire and participate in one of the three focus groups including (1) patients; (2) physical therapists; and (3) a patient, a physical therapist, and stakeholders from the health care system. The focus groups were used to determine concordance with the results of the interviews and the online questionnaire. Results: Nine physical therapists, seven patients, and six stakeholders confirmed that an increase of acceptance of the digital care part by physical therapists and patients is crucial. One of the most frequently mentioned facilitators was conducting regular in-person sessions. Physical therapists and patients concluded that blended physical therapy must be tailored to the patients' needs. Participants of the last focus group stated that the reimbursement of blended physical therapy needs to be clarified. Conclusions: Most importantly, it is necessary to strengthen the acceptance of patients and physical therapists toward digital care. Overall, fo
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More and more local bottom-up energy initiatives are emerging. Those involved encounter many barriers during the realization of their ideas. As the generation of renewable energy is mostly included, these local initiatives contribute to the targets set at regional, national & EU level. At the same time, they are an indication that end-users themselves want to be part of the energy transition. What are the reasons for citizens to organize themselves and start and initiative? What kind of barriers do they encounter? What does this mean for roles and responsibilities of professionals? And to what kind of opportunities does this lead for products and services? Answers to these questions provide a solid starting point to develop methods and instruments to stimulate,facilitate and upscale local energy initiatives. This paper bundles the outcomes of three workshops and three additional interviews in the Netherlands as part of the European E-hub project. Conclusions can be drawn on needs and drivers, barriers, risks and solutions (lessons learned), possible roles for professionals and opportunities for new products and services.
Aim and objectives: To provide an in-depth insight into the barriers, facilitators and needs of district nurses and nurse assistants on using patient outcomes in district nursing care. Background: As healthcare demands grow, particularly in district nursing, there is a significant need to understand how to systematically measure and improve patient outcomes in this setting. Further investigation is needed to identify the barriers and facilitators for effective implementation. Design: A multi-method qualitative study. Methods: Open-ended questions of a survey study (N = 132) were supplemented with in-depth online focus group interviews involving district nurses and nurse assistants (N = 26) in the Netherlands. Data were analysed using thematic analysis. Results: Different barriers, facilitators and needs were identified and compiled into 16 preconditions for using outcomes in district nursing care. These preconditions were summarised into six overarching themes: follow the steps of a learning healthcare system; provide patient-centred care; promote the professional's autonomy, attitude, knowledge and skills; enhance shared responsibility and collaborations within and outside organisational boundaries; prioritise and invest in the use of outcomes; and boost the unity and appreciation for district nursing care. Conclusions: The preconditions identified in this study are crucial for nurses, care providers, policymakers and payers in implementing the use of patient outcomes in district nursing practice. Further exploration of appropriate strategies is necessary for a successful implementation. Relevance to clinical practice: This study represents a significant step towards implementing the use of patient outcomes in district nursing care. While most research has focused on hospitals and general practitioner settings, this study focuses on the needs for district nursing care. By identifying 16 key preconditions across themes such as patient-centred care, professional autonomy and unity, the findings offer valuable guidance for integrating a learning healthcare system that prioritises the measurement and continuous improvement of patient outcomes in district nursing.
Dit project omvat een verkennend onderzoek dat beoogt de technische route, de scope en de randvoorwaarden van de energietransitie op vakantieparken en campings in beeld te brengen. De sector voor vakantieparken en campings zal, net als alle andere sectoren, binnen dertig jaar nul-emissies van broeikasgassen moeten bereiken. De gemeente Goeree-Overflakkee en de Provincie Zuid-Holland zijn voornemens om een project op te zetten om de voor Goeree-Overflakkee belangrijke sector te helpen de energietransitie te maken. De gemeente en provincie willen graag antwoord op de vraag welke kennis en welke partijen nodig zijn om de duurzaamheidsdoelstelling zodanig in een beleidsproces te gieten dat de belangen van de vele stakeholders in deze sector samenkomen op een wijze dat de doelstelling gehaald wordt.This project entails an exploratory study that aims to map the technical route, scope and preconditions of the energy transition at holiday parks and campsites. The holiday park and camping sector, like all other sectors, will have to achieve zero greenhouse gas emissions within thirty years. The municipality of Goeree-Overflakkee and the Province of South Holland intend to set up a project to help this important sector on Goeree-Overflakkee to make the energy transition. The municipality and province would like an answer to the question of what knowledge and which parties are needed to put the sustainability objective into a policy process in such a way that the interests of the many stakeholders in this sector come together in a way that the objective is achieved.
