Klienten und ihr System im Detail betrachten–Person Environment Occupation Performance (PEOP) Model

Das PEOP-Modell geht davon aus, dass sich Person, Umwelt und Betätigung gegenseitig beeinflussen. Damit tragen sie zu Partizipation, Performanz und Wohlbefinden bei. Das Modell ist eine Unterstützung für Ergotherapeuten, um die Betätigungsanliegen ihrer Klienten ganzheitlich zu betrachten

Samen evalueren met de doelgroep: lessen uit de ontwikkeling van een participatief evaluatie-instrument

Samenvatting: Bij het evalueren van gezondheidsbevordering is het van belang de beoogde doelgroep erbij te betrekken. In de praktijk wordt participatieve evaluatie echter nog onvoldoende ingezet. Om professionals te helpen de doelgroep bij de evaluatie te betrekken werd hiervoor in het kader van de JOGG-aanpak (Gezonde Jeugd, Gezonde Toekomst, voorheen: Jongeren Op Gezond Gewicht) een instrument ontwikkeld. Hoewel het samen met de JOGG-professionals is ontwikkeld, bleek dit instrument niet goed aan te sluiten bij hun behoeften. In dit artikel reflecteren we op hoe dit komt en delen we de geleerde lessen. Ongelijkwaardige samenwerking tussen onderzoekers en professionals heeft er aan bijgedragen dat praktijkbehoeften onvoldoende in het evaluatie-instrument zijn meegenomen. Daarnaast ervaren professionals zelf verschillende uitdagingen bij participatieve evaluatie, omdat de context waarin zij werken hen hierin onvoldoende faciliteert. Abstract: Participation of the target group is important in evaluating health promotion. However, in practice the use of participatory evaluation is still limited. To support professionals within the JOGG (Healthy Youth, Healthy Future, previously Youth At a Healthy Weight) rogramme with participatory evaluation a tool was developed. Although this tool was developed with professionals, it did not meet their needs. In this article we reflect on the development of the tool and share lessons learned. Unequal collaboration between researchers and professionals may have contributed to the needs of professionals being insufficiently taken into account. Additionally, professionals themselves experience challenges with participatory evaluation, because the context in which they work does not facilitate participatory evaluation

Customised care: Post Intensive Care Syndrome

Physiotherapy, Dietetics and Occupational Therapy have been collaborating over recent years to develop an optimal healthcare programme for patients with Post Intensive Care Syndrome (PICS). This case is an example of PICS symptomatology and focuses on the collaboration between Physiotherapy and Dietetics. What is PICS? Owing to healthcare improvements, more and more patients are surviving the intensive Care Unit (ICU), and recovery during and after ICU stay has been receiving more attention [1, 2]. Approximately 30% of the patients admitted to an ICU have persistent symptoms including muscle weakness, reduced walking ability, fatigue, concentration deficits, memory problems, malnutrition, sleep and mood disorders sometimes even years after discharge [3-8]. Since 2012, this combination of physical, cognitive and psychiatric manifestations and reduced quality of life after staying in an ICU has been recognised as Post Intensive Care Syndrome (PICS) [9]. The impact of PICS is often not limited to the patient as it may also impact the mental status of the patient’s immediate family. This is known as PICS-Family (PICS-F) [10-12]. Treatment of PICS: Approximately 80% of PICS patients need primary care physiotherapy. Physiotherapists and GPs are often the only primary care professionals involved in the recovery process of these patients after hospital discharge [13, 14]. Both patients and healthcare professionals report a number of difficulties, e.g. limited transmural continuity in healthcare, coordination of multidisciplinary activities, supportive treatment guidelines and specific knowledge of pathology, treatment and prognosis. Patients report that they are not adequately supported when resuming their professional activities and that medical and allied healthcare treatments do not fully meet their needs at that time [15-18]. The REACH project: In order to improve the situation, the REACH project (REhabilitation After Critical illness and Hospital discharge) was started in Amsterdam region in the Netherlands. Within REACH, a Community of Practice – consisting of professionals (physiotherapists, occupational therapists, dieticians), those who live or have lived with the condition and researchers – has developed a transmural rehab programme. A special attribute of this programme is the integration of the concept of “positive health”. The case in this article describes the treatment of a PICS patient treated within the REACH network

How to best distribute written patient education materials among patients with rheumatoid arthritis: a randomized comparison of two strategies

Abstract Background The aim of this randomized controlled trial was to evaluate the effect of a ‘supply on demand’-distribution strategy, compared to an ‘unsolicited supply’-distribution strategy, on the use of a care booklet and clinical outcomes among patients with rheumatoid arthritis (RA). In addition, differences in socio-demographic and clinical characteristics between users and non-users were explored. Methods As part of regular care the care booklet was distributed among RA-patients of two hospitals in the Netherlands. 1000 patients received the care booklet by mail, whereas another 1000 received an information letter with the option to order the care booklet. Four months after distribution, a random sample of 810 patients (stratified by hospital and distribution method) received a questionnaire on the use of the booklet, social-demographic and clinical characteristics. To compare effects between the two distribution strategies and differences between users and non-users univariate and multilevel regression analyses were performed. Secondary analysis included a per-protocol analysis (excluding participants who did not order the care booklet). Results One hundred ninety four patients in the ‘unsolicited supply’ and 176 patients in the ‘supply on demand’ group (46%) returned the questionnaire. In the ‘supply on demand’ group 106 (60.2%) participants ordered the care booklet. In total, no difference was found in use between the ‘unsolicited supply’-group (23.2%) and the ‘supply on demand’-group (21.6%) (OR 0.9 CI:0.6–1.5). However, the proportion of users among patients in the ‘supply on demand’-group who ordered the booklet (35%) was significantly higher than in the ‘unsolicited supply’-group (OR 1.9 CI:1.1–3.2). Regardless of distribution method, use of the care booklet was associated with being married (OR 2.4 CI:1.2–4.6), higher disease activity (mean difference 0.5 CI: 0.0–1.1), more activity limitations (mean difference 0.2 CI: 0.1–0.4), use of corticosteroids (OR 1.9 CI:1.0–3.5), perception of disease course as fluctuating (mean difference 1.4 CI:0.5–2.3) and higher educational needs (mean difference 9.7 CI: 2.9–16.6). Conclusions From an economic and environmental perspective a ‘supply on demand’-distribution strategy could be recommended. Results of this study provide starting points to optimize further implementation strategies of a care-booklet in routine care. Trial registration ISRCTN registry (ISRCTN22703067). Retrospectively registered 27 March 2017