Health professionals’ sentiments towards implemented information technologies in psychiatric hospitals: a text-mining analysis

Background Psychiatric hospitals are increasingly being digitalised. Digitalisation often requires changes at work for health professionals. A positive attitude from health professionals towards technology is crucial for a successful and sustainable digital transformation at work. Nevertheless, insufficient attention is being paid to the health professionals’ sentiments towards technology. Objective This study aims to identify the implemented technologies in psychiatric hospitals and to describe the health professionals’ sentiments towards these implemented technologies. Methods A text-mining analysis of semi-structured interviews with nurses, physicians and psychologists was conducted. The analysis comprised word frequencies and sentiment analyses. For the sentiment analyses, the SentimentWortschatz dataset was used. The sentiments ranged from -1 (strongly negative sentiment) to 1 (strongly positive sentiment). Results In total, 20 health professionals (nurses, physicians and psychologists) participated in the study. When asked about the technologies they used, the participating health professionals mainly referred to the computer, email, phone and electronic health record. Overall, 4% of the words in the transcripts were positive or negative sentiments. Of all words that express a sentiment, 73% were positive. The discussed technologies were associated with positive and negative sentiments. However, of all sentences that described technology at the workplace, 69.4% were negative. Conclusions The participating health professionals mentioned a limited number of technologies at work. The sentiments towards technologies were mostly negative. The way in which technologies are implemented and the lack of health professionals’ involvement seem to be reasons for the negative sentiments

Interventies bij het signaleren van pijn bij verpleeghuisbewoners met dementie: de pilot implementatie van een pijnbeoordelingsinstrument (PACSLAC-D)

Pijn bij dementerende verpleeghuisbewoners komt veelvuldig voor. Er zijn aanwijzingen dat de inzet van structurele pijnbeoordeling kan bijdragen aan adequate signalering van pijn. Dit onderzoek heeft als doel inzicht te krijgen in de toegepaste interventies na het vaststellen van pijn met een observationele pijnschaal (PACSLAC-D) bij verpleeghuisbewoners met dementie. Gedurende zes weken werd bij 22 bewoners van een psychogeriatrische verpleeghuisafdeling op twee vaste dagen in de week pijn gemeten met behulp van de PACSLAC-D. Interventies naar aanleiding van een pijnscore werden geïnventariseerd op een datasheet. Na drie en zes weken vond er een evaluatie plaats naar de invoering van de pijnmeting. In totaal werden er 264 pijnmetingen met behulp van de PACSLAC-D uitgevoerd. Van de geplande standaardmetingen werden er 90% verricht. Zestig maal bleek er sprake van een pijnscore. Uit volledig ingevulde datasheets (N=39) kwam naar voren dat er naar aanleiding van een pijnscore veelal (N=17) geen interventie werd verricht. Wanneer er wel een interventie volgde (N=22) bestond deze voornamelijk uit een niet-medicamenteuze behandeling (N=19). Uit de evaluatiebijeenkomsten bleek dat pijnbeoordeling bruikbaar was, maar de gekozen onderzoeksopzet met twee standaard meetmomenten per week niet optimaal. Op basis van dit onderzoek kan worden geconcludeerd dat, ondanks dat de verpleging systematisch pijn mat, er weinig gebruik werd gemaakt van pijnverlichtende interventies

Co-creative development of an eHealth nursing intervention: Self-management support for outpatients with cancer pain

Introduction Co-creative methods, having an iterative character and including different perspectives, allow for the development of complex nursing interventions. Information about the development process is essential in providing justification for the ultimate intervention and crucial in interpreting the outcomes of subsequent evaluations. This paper describes a co-creative method directed towards the development of an eHealth intervention delivered by registered nurses to support self-management in outpatients with cancer pain. Methods Intervention development was divided into three consecutive phases (exploration of context, specification of content, organisation of care). In each phase, researchers and technicians addressed five iterative steps: research, ideas, prototyping, evaluation, and documentation. Health professionals and patients were consulted during research and evaluation steps. Results Collaboration of researchers, health professionals, patients and technicians was positive and valuable in optimising outcomes. The intervention includes a mobile application for patients and a web application for nurses. Patients are requested to monitor pain, adverse effects and medication intake, while being provided with graphical feedback, education and contact possibilities. Nurses monitor data, advise patients, and collaborate with the treating physician. Conclusion Integration of patient self-management and professional care by means of eHealth key into well-known barriers and seem promising in improving cancer pain follow-up. Nurses are able to make substantial contributions because of their expertise, focus on daily living, and their bridging function between patients and health professionals in different care settings. Insights from the intervention development as well as the intervention content give thought for applications in different patients and care settings

thcare resource utilisation by critically ill older patients following an intensive care unit stay

Aims and objectivesThis study examines the utilisation of healthcare resources by critically ill older patients over one year following an intensive care unit stay. BackgroundInformation on healthcare resource utilisation following intensive care unit treatment is essential during times of limited financial resources. DesignProspective longitudinal nonrandomised study. MethodsHealthcare resource utilisation by critically ill older patients (65years) was recorded during one year following treatment in a medical-surgical intensive care unit. Age-matched community-based participants served as comparison group. Data were collected at one-week following intensive care unit discharge/study recruitment and after 6 and 12months. Recorded were length of stay, (re)admission to hospital or intensive care unit, general practitioner and medical specialist visits, rehabilitation program participation, medication use, discharge destination, home health care service use and level of dependence for activities of daily living. ResultsOne hundred and forty-five critically ill older patients and 146 age-matched participants were recruited into the study. Overall, critically ill older patients utilised more healthcare resources. After 6 and 12months, they visited general practitioners six times more frequently, twice as many older patients took medications and only the intensive care unit group patients participated in rehabilitation programs (n=99, 76%). The older patients were less likely to be hospitalised, very few transferred to nursing homes (n=3, 2%), and only 7 (6%) continued to use home healthcare services 12months following the intensive care unit stay. ConclusionsCritically ill older patients utilise more healthcare resources following an intensive care unit stay, however, most are able to live at home with no or minimal assistance after one year. Relevance to clinical practiceAdequate healthcare resources, such as facilitated access to medical follow-up care, rehabilitation programs and home healthcare services, must be easily accessible for older patients following hospital discharge. Nurses need to be aware of the healthcare services available and advise patients accordingly

The use of facial expressions for pain assessment purposes in dementia: A narrative review

Facial expressions convey reliable nonverbal signals about pain and thus are very useful for assessing pain in patients with limited communicative ability, such as patients with dementia. In this review, we present an overview of the available pain observation tools and how they make use of facial expressions. Utility and reliability of facial expressions to measure pain in dementia are discussed, together with the effect of dementia severity on these facial expressions. Next, we present how behavioral alterations may overlap with facial expressions of pain, and may even influence the extent to which pain is facially expressed. The main focus is on disinhibition, apathy and emotional changes. Finally, an overview of theoretical considerations and practical implications is presented for assessing pain using facial expressions in clinical settings

The prevalence of pain in nursing home residents with dementia measured using an observational pain scale.

Contains fulltext : 81234.pdf (publisher's version ) (Closed access)BACKGROUND: Studies on pain and pain prevalence in older people with dementia are limited compared to those on cognitively intact older people. Pain prevalence rates in older people with dementia are estimated to be between 28% and 83%. AIMS: This study aimed to explore pain prevalence in nursing home residents with dementia using observational scale PACSLAC-D, and to identify the association between pain prevalence and (dementia) demographic parameters such as cognitive status, gender, analgesic use and co-morbidity. METHODS: Using an observational study design, 117 residents were observed and assessed for pain during personal morning care. Prevalence data were calculated and regression analyses applied. RESULTS: This study showed that almost half of the participants (47%) experienced pain to some extent. However, overall pain intensity scores were relatively mild. Among the independent variables, co-morbidities, analgesic use and the adjusted interaction term 'co-morbidities+analgesic use' had the strongest associations with pain and were thus shown to be valid significant predictors. CONCLUSION: With its relatively new approach of measuring pain using an observational scale, this study confirms the expectation gleaned from other studies on less impaired older populations: namely, that pain prevalence in older residents with dementia in Dutch nursing homes is high

Long-term consequences of pain, anxiety and agitation for critically ill older patients after an intensive care unit stay

Aims and objectivesThis study investigated whether an intensive care unit (ICU) stay is associated with persistent pain, anxiety and agitation in critically ill older patients. BackgroundPatients hospitalised in the ICU are at risk for experiencing pain, anxiety and agitation, but long-term consequences for older patients have rarely been investigated. DesignProspective nonrandomised longitudinal study. MethodsPain, anxiety and agitation, measured with a numeric rating scale (0-10), were assessed in older patients (65years) hospitalised in the medical-surgical ICU of a university hospital. Agitation during the ICU was assessed with the Richmond Agitation-Sedation Scale. Data collection occurred during the ICU, one week after the stay and six and 12months after hospital discharge. Data were collected from an age-matched community-based comparison group at recruitment and after six and 12months. Study recruitment took place from December 2008-April 2011. ResultsThis study included 145 older patients (ICU group) and 146 comparison group participants. Pain was higher in the ICU group one week after discharge, although pain levels in general were low. Both groups reported no or low levels of pain after six and 12months. Anxiety levels in general were low, although higher in the ICU group one week after ICU discharge. After six and 12months, anxiety in both groups was comparable. Throughout the study, levels of agitation were similar in both groups. ConclusionsCritically ill older patients did not experience increased pain, anxiety or agitation 12months after an ICU stay. Relevance to clinical practiceThis study positively shows that an ICU stay is not associated with persistent pain, anxiety and agitation thus providing additional information to older patients and their families when making intensive care treatment decisions. Adequate management of pain during and after an ICU stay may minimise the suffering of older patients

Health professionals’ sentiments towards implemented information technologies in psychiatric hospitals: a text-mining analysis

Abstract Background Psychiatric hospitals are increasingly being digitalised. Digitalisation often requires changes at work for health professionals. A positive attitude from health professionals towards technology is crucial for a successful and sustainable digital transformation at work. Nevertheless, insufficient attention is being paid to the health professionals’ sentiments towards technology. Objective This study aims to identify the implemented technologies in psychiatric hospitals and to describe the health professionals’ sentiments towards these implemented technologies. Methods A text-mining analysis of semi-structured interviews with nurses, physicians and psychologists was conducted. The analysis comprised word frequencies and sentiment analyses. For the sentiment analyses, the SentimentWortschatz dataset was used. The sentiments ranged from -1 (strongly negative sentiment) to 1 (strongly positive sentiment). Results In total, 20 health professionals (nurses, physicians and psychologists) participated in the study. When asked about the technologies they used, the participating health professionals mainly referred to the computer, email, phone and electronic health record. Overall, 4% of the words in the transcripts were positive or negative sentiments. Of all words that express a sentiment, 73% were positive. The discussed technologies were associated with positive and negative sentiments. However, of all sentences that described technology at the workplace, 69.4% were negative. Conclusions The participating health professionals mentioned a limited number of technologies at work. The sentiments towards technologies were mostly negative. The way in which technologies are implemented and the lack of health professionals’ involvement seem to be reasons for the negative sentiments