Browse by Lectorate "Neurorevalidatie"

Now showing items 51-100 of 148

Process-oriented profiling of speech sound disorders
Diepeveen, S.J.H. ; Terband, H ; Haaften, L van ; Zande, A.M. ; Megens-Huigh, C. ; Swart, B.J.M. de ; Maassen, B
2022, Article / Letter to editor (CHILDREN-BASEL, vol. 9, iss. 1502, (2022), pp. 1-23)
Prevalence of oropharyngeal dysphagia in Parkinson’s disease : A meta-analysis
Bloem, Bastiaan ; Kalf, Johanna ; Munneke, Marten ; Swart, B.J.M. de
2012, Article / Letter to editor (Parkinsonism & Related Disorders, vol. 18, iss. 4, (2012), pp. 311-315)Dysphagia is a potentially harmful feature, also in Parkinsons disease (PD). As published prevalence rates vary widely, we aimed to estimate the prevalence of oropharyngeal dysphagia in PD in a meta-analysis. We conducted a systematic literature search in February 2011 and two independent reviewers selected the papers. We computed the estimates of the pooled prevalence weighted by sample size. Twelve studies were suitable for calculating prevalence rates. Ten studies provided an estimate based on subjective outcomes, which proved statistically heterogeneous (p < 0.001), with a pooled prevalence estimate with random effect analysis of 35% (95% CI 28-41). Four studies provided an estimate based on objective measurements, which were statistically homogeneous (p = 0.23), with a pooled prevalence estimate of 82% (95% CI 77-87). In controls the pooled subjective prevalence was 9% (95% CI 2-17), while the pooled objective prevalence was 23% (95% CI 13-32). The pooled relative risk was 3.2 for both subjective outcomes (95% CI 2.32-4.41) and objective outcomes (95% CI 2.08-4.98). Clinical heterogeneity between studies was chiefly explained by differences in disease severity. Subjective dysphagia occurs in one third of community-dwelling PD patients. Objectively measured dysphagia rates were much higher, with 4 out of 5 patients being affected. This suggests that dysphagia is common in PD, but patients do not always report swallowing difficulties unless asked. This underreporting calls for a proactive clinical approach to dysphagia, particularly in light of the serious clinical consequences.
Performing occupations under pain: the experience of persons with chronic pain.
Aegler, B. ; Satink, T.
2009, Article / Letter to editor (Scandinavian Journal of Occupational Therapy, vol. 16, iss. 1, (2009), pp. 49-56)Chronic pain is known as a complex and subjective phenomenon that challenges healthcare professionals who coach and support clients with chronic pain. The aim of this study was to explore how persons with chronic pain experienced their occupational performance. Eight persons suffering from chronic pain were interviewed and the data was analysed with the constant comparative method. Three themes were identified: "Performing is an ongoing attraction", "Getting used to taking breaks is not easy", and "The challenge to finish performing". "Performing is an ongoing attraction" illustrates the innate need of every human being to be active and also how pleasurable occupations do not influence pain. The ongoing thoughts and emotions while participants stop their performance are described in "Getting used to taking breaks is not easy". This stop and go during every occupation is discussed in the perspective of temporality and occupational performance. In "The challenge to finish performing" the participants describe how they complete certain occupations despite pain. This is discussed with the focus on distraction and flow experience.
Perceive, Recall, Plan and Perform (PRPP)-Assessment Based on Parent-Provided Videos of Children with Mitochondrial Disorder: Action Design Research on Implementation Challenges.
Lindenschot, M. ; Groot, I.J.M. de ; -van der Sanden, M.W.G. Nijhuis ; Steultjens, E.M.J. ; Graff, M.J.L. ; Koene, S.
2023, Article / Letter to editor (Physical and Occupational Therapy in Pediatrics, vol. 43, iss. 1, (2023), pp. 74-92)AIMS: Performing the Perceive, Recall, Plan and Perform (PRPP)-Assessment, using video material of everyday life, seems sensible to lower the patient burden, enhance ecological validity, and provide care at a distance. However, receipt of adequate video material is not self-evident and assessing videos can be challenging. Therefore, this study aims to optimize the process of gaining video material and to optimize the PRPP-Assessment based on parent-provided videos. METHODS: An action design research method was used, focusing on implementation of the PRPP-Assessment based on parent-provided videos within the care of children with a mitochondrial disorder or similar symptoms. RESULTS: Five cycles were conducted. To receive input, the cycles used videos of nine children performing activities, written feedback, and semi-structured interviews and focus groups comprising parents (nn=n13), a teacher (nn=n1), occupational therapists (nn=n16), and other professionals (nn=n2) . This led to successful implementation of the PRPP-Assessment. General lessons were learned on (1) instructing parents; (2) handling video material; (3) PRPP-Assessment based on parent-provided videos; and (4) PRPP-Assessment of children (with limited functional abilities). CONCLUSIONS: Lessons learned should be implemented in practice and are incorporated into a manual to guide the implementation of video-based observations with PRPP-Assessment in practice.
Patients' Views on the Impact of Stroke on Their Roles and Self: A Thematic Synthesis of Qualitative Studies
Satink, T. ; Cup, Edith ; Ilott, I ; Prins, J ; Swart, B.J.M. de ; Nijhuis-van der Sanden, M.W.G.
2013, Article / Letter to editor (Archives of Physical Medicine and Rehabilitation, vol. 94, iss. 6, (2013), pp. 1171-1183)Objective: To synthesize patients' views on the impact of stroke on their roles and self. Data Sources: PubMed, CINAHL, Embase, PsycINFO, and Cochrane searched from inception to September 2010, using a combination of relevant Medical Subject Headings and free-text terms. This search was supplemented by reference tracking. Study Selection: Qualitative studies reporting the views of people poststroke. The search yielded 494 records. Opinion articles, quantitative studies, or those reporting somatic functioning were excluded. Thirty-three studies were included. Data Extraction: Data extraction involved identifying all text presented as "results" or "findings" in the included studies, and importing this into software for the analysis of qualitative data. Data Synthesis: The abstracted text was coded and then subject to a thematic analysis and synthesis, which was discussed and agreed by the research team. Three overarching themes were identified: (1) managing discontinuity is a struggle; (2) regaining roles: to continue or adapt? and (3) context influences management of roles and self. Regaining valued roles and self was an ongoing struggle, and discontinuity and uncertainty were central to the adjustment process after stroke. Conclusions: The thematic synthesis provides new insights into the poststroke experience. Regaining or developing a new self and roles was problematic. Interventions targeted at self-management should be focused on the recognition of this problem and included in rehabilitation, to facilitate adjustment and continuity as far as possible in life poststroke. (C) 2013 by the American Congress of Rehabilitation Medicine
Pathophysiology of diurnal drooling in Parkinson’s disease
Engel-Hoek, Lenie van den ; Kalf, Johanna ; Bloem, Bastiaan ; Borm, George ; Zwarts, Machiel ; Swart, B.J.M. de ; Munneke, Marten
2011, Article / Letter to editor (Movement Disorders, vol. 26, iss. 9, (2011), pp. 1670-1676)Drooling is an incapacitating feature of Parkinsons disease. Better pathophysiological insights are needed to improve treatment. In this study, we tested the hypothesis that the cause of drooling is multifactorial. We examined 15 patients with Parkinsons disease with distinct diurnal saliva loss ("droolers") and 15 patients with Parkinsons disease without drooling complaints ("nondroolers"). We evaluated all factors that could potentially contribute to drooling: swallowing capacity (maximum volume), functional swallowing (assessed with the dysphagia subscale of the Therapy Outcome Measures for rehabilitation specialists), unintentional mouth opening due to hypomimia (Unified Parkinsons Disease Rating Scale item), posture (quantified from sagittal photographs), and nose-breathing ability. We also quantified the frequency of spontaneous swallowing during 45 minutes of quiet sitting, using polygraphy. Droolers had more advanced Parkinsons disease than nondroolers (Unified Parkinsons Disease Rating Scale motor score 31 vs 22; P=.014). Droolers also scored significantly worse on all recorded variables except for nose breathing. Swallowing frequency tended to be higher, possibly to compensate for less efficient swallowing. Logistic regression with adjustment for age and disease severity showed that hypomimia correlated best with drooling. Linear regression with hypomimia as the dependent variable identified disease severity, dysphagia, and male sex as significant explanatory factors. Drooling in Parkinsons disease results from multiple risk factors, with hypomimia being the most prominent. When monitored, patients appear to compensate by increasing their swallowing frequency, much like the increased cadence that is used to compensate for stepping akinesia. These findings can provide a rationale for behavioral approaches to treat drooling.
Organizational leadership, health risk screening, individually tailored programs, and supportive workplace culture might reduce presenteeism
Steultjens, E.M.J. ; Baker, E. ; Aas, N. ; Randi, W.
2012, Article / Letter to editor (Australian Occupational Therapy Journal, vol. 59, iss. 3, (2012), pp. 247-250)To determine if Workplace Health Promotion programs (WHPs) are effective in improving presenteeism. The secondary objective was to identify characteristics of successful programmes and potential risk factors for presenteeism. The Cochrane Library, Medline and other electronic databases were searched from 1990 to January 2010 for all studies that examined WHP. A highly sensitive search strategy was used including reference list checking, hand searching, and contacting researchers. Fourteen studies (four strong and ten moderate methodological quality) were eligible for inclusion. A further 33 were considered ineligible for inclusion due to methodological weakness. The 14 eligible studies contained preliminary evidence for a positive effect of some WHP programs. Successful programs offered organizational leadership, health risk screening, individually tailored programs, and a supportive workplace culture. Potential risk factors contributing to presenteeism included being overweight, poor diet, lack of exercise, high stress, and poor relations with co-workers and management. There is preliminary evidence that some WHP programs can positively affect presenteeism and that certain risk factors are of importance. The presenteeism literature is young and heterogeneous.
Oral muscles are progressively affected in Duchenne muscular dystrophy : Implications for dysphagia treatment
Swart, B.J.M. de ; Klein, W. ; Engel-Hoek, Lenie van den ; Pillen, S. ; Hendriks, J.C.M. ; Geurts, Alexander ; Groot, M. de ; Sie, L. ; Erasmus, C.
2012, Article / Letter to editor (Journal of Neurology, vol. 260, iss. 5, (2012), pp. 1295-1303)Dysphagia is reported in advanced stages of Duchenne muscular dystrophy (DMD). The population of DMD is changing due to an increasing survival. We aimed to describe the dysphagia in consecutive stages and to assess the underlying mechanisms of dysphagia in DMD, in order to develop mechanism based recommendations for safe swallowing. In this cross-sectional study, participants were divided into: early and late ambulatory stage (AS, n = 6), early non-ambulatory stage (ENAS, n = 7), and late non-ambulatory stage (LNAS, n = 11). Quantitative oral muscle ultrasound was performed to quantify echo intensity. Swallowing was assessed with a video fluoroscopic swallow study, surface electromyography (sEMG) of the submental muscle group and tongue pressure. Differences in outcome parameters among the three DMD stages were tested with analysis of variance. Oral muscles related to swallowing were progressively affected, starting in the AS with the geniohyoid muscle. Tongue (pseudo) hypertrophy was found in 70 % of patients in the ENAS and LNAS. Oral phase problems and post-swallow residue were observed, mostly in the LNAS with solid food. sEMG and tongue pressure data of swallowing solid food revealed the lowest sEMG amplitude, the longest duration and lowest tongue pressure in the LNAS. In case of swallowing problems in DMD, based on the disturbed mechanisms of swallowing, it is suggested to (1) adjust meals in terms of less solid food, and (2) drink water after meals to clear the oropharyngeal area.
Opening the black box of non-pharmacological care in systemic sclerosis: a cross-sectional online survey of Dutch health professionals
Stöcker, J.K. ; Vonk, M.C. ; Hoogen, F.H.C. van den ; Nijhuis-van der Sanden, M.W.G. ; Spierings, J ; Staal, J.B. ; Satink, T. ; Ende, C.H.M.
2020, Article / Letter to editor (Rheumatology International, (2020))
Ontwikkeling van criteria voor indicatiestelling fysiotherapie binnen verpleeghuizen
Hobbelen, H. ; Leemrijse, C. ; Ravensberg, Dorine van ; Koopmans, R.T. ; Swart, B.J.M. de ; Haastert, C. van ; Veenhof, C.
2011, Article / Letter to editor (Fysiotherapie en Ouderenzorg, vol. 25, iss. 3, (2011), pp. 5-16)Er bestaat een grote variatie in het percentage bewoners per verpleeghuis dat wel of geen fysiotherapeutische zorg ontvangt. Hierdoor is het onduidelijk of de juiste groep wel fysiotherapie ontvangt. Er is dan ook behoefte aan meer transparantie en standaardisatie van de indicatiestelling fysiotherapie in verpleeghuizen. Het doel van deze studie is om criteria te ontwikkelen voor de indicatiestelling fysiotherapie in verpleeghuizen en deze te toetsen in de praktijk.
Occupational therapy for care home residents with stroke
Sackley, C. ; Walker, M. ; Steultjens, E.M.J. ; Feltham, M. ; Fletcher-Smith, J.
2012, Article / Letter to editor (The Cochrane Library, vol. 2012, iss. 10, (2012))In this systematic review we aim to measure the effects of occupational therapy interventions (provided directly by an occupational therapist or under the supervision of an occupational therapist) targeted at improving, restoring and maintaining independence in ADL (to include both self-care and leisure activities) among stroke survivors residing in long-term institutional care termed collectively as ’care homes’ (care homes, residential homes, nursing homes, aged-care facilities, long-term care institutions, and older peoples homes). As a secondary outcome we will also evaluate occupational therapy interventions aimed at reducing complications such as depression and low mood.
Nursing home-acquired pneumonia, dysphagia and associated diseases in nursing home residents: A retrospective, cross-sectional study
Hollaar, V.R.Y. ; Putten, GJ van der ; Van der Maarel -Wierink, CD ; Bronkhorst, E.M. ; Swart, B.J.M. de ; Baat, C de ; Creugers, N.H.J.
2017, Article / Letter to editor (Geriatric Nursing, vol. 38, (2017), pp. 437-441)
Normen van de Peabody Picture Vocabulary Test-III-NL; Voldoen de normen voor jongvolwassenen nog? Een verkennend onderzoek
Bekering, S ; Remijn, C.S.M.
2020, Article / Letter to editor (Nederlands Tijdschrift voor Logopedie, (2020))
Normen van de Peabody Picture Vocabulary Test-III-NL
Bekering, S ; Alons, E ; Daatselaar, M ; van Sasse van IJsselt, M ; Suidman, L ; Remijn, C.S.M. ; Bruinsma, G
2020, Article / Letter to editor (Nederlands Tijdschrift voor Logopedie, vol. 92, iss. 6, (2020), pp. 18-25)
Neurostimulation in People with Oropharyngeal Dysphagia: A Systematic Review and Meta-Analyses of Randomised Controlled Trials-Part I: Pharyngeal and Neuromuscular Electrical Stimulation.
Speyer, R. ; Sutt, A.L. ; Bergström, L. ; Hamdy, S. ; Heijnen, B.J. ; Remijn, L. ; Wilkes-Gillan, S. ; Cordier, R.
2022, Article / Letter to editor (J Clin Med, vol. 11, iss. 3, (2022))Objective. To assess the effects of neurostimulation (i.e., neuromuscular electrical stimulation (NMES) and pharyngeal electrical stimulation (PES)) in people with oropharyngeal dysphagia (OD). Methods. Systematic literature searches were conducted to retrieve randomised controlled trials in four electronic databases (CINAHL, Embase, PsycINFO, and PubMed). The methodological quality of included studies was assessed using the Revised Cochrane risk-of-bias tool for randomised trials (RoB 2). Results. In total, 42 studies reporting on peripheral neurostimulation were included: 30 studies on NMES, eight studies on PES, and four studies on combined neurostimulation interventions. When conducting meta analyses, significant, large and significant, moderate pre-post treatment effects were found for NMES (11 studies) and PES (five studies), respectively. Between-group analyses showed small effect sizes in favour of NMES, but no significant effects for PES. Conclusions. NMES may have more promising effects compared to PES. However, NMES studies showed high heterogeneity in protocols and experimental variables, the presence of potential moderators, and inconsistent reporting of methodology. Therefore, only conservative generalisations and interpretation of meta-analyses could be made. To facilitate comparisons of studies and determine intervention effects, there is a need for more randomised controlled trials with larger population sizes, and greater standardisation of protocols and guidelines for reporting.
NEON (Netwerk Ergotherapie Onderzoekers Nijmegen) stelt zich voor
Hartingsveldt, Margo van ; Sturkenboom, Ingrid ; Graff, Maud ; Satink, T. ; Cup, Edith
2009, Article / Letter to editor (Wetenschappelijk Tijdschrift voor Ergotherapie, vol. 2009, iss. 4, (2009), pp. 24-26)NEON is een Netwerk voor Ergotherapie Onderzoekers in de regio Nijmegen. Een van de doelstellingen van NEON is dat het een bijdrage wil leveren aan visieontwikkeling en uitvoering van ergotherapieonderzoek. In dit artikel stelt NEON zich kort aan u voor, gaan we in op de voordelen van het samenwerkingsverband en geven we een korte reactie op de Europese onderzoeksagenda.
Negotiating role management through everyday activities: narratives in action of two stroke survivors and their spouses
Satink, T. ; Josephsson, S ; Zajec, J. ; Cup, Edith ; Swart, B.J.M. de ; Nijhuis-van der Sanden, M.W.G.
2016, Article / Letter to editor (Disability and Rehabilitation, vol. 38, iss. 24-26, (2016), pp. 2354-2364)Purpose: To manage social roles is a challenging part of self-management post-stroke. This study explored how stroke survivors act as role managers with their spouses in the context of everyday activities. Method: Two stroke survivors with a first time stroke living at home with a spouse were included. Data were generated through participant observations at their own environment at 3, 6, 9, 15 and 21 months post-discharge. The narrative analysis focused on the actions of participants. Results: Daily activities can be understood as an arena where role management and a meaningful live is negotiated and co-constructed with others. Everyday activities gave stroke survivors and their spouses insight into stroke survivors' capacities in daily situations. This was sometimes empowering, and other times conflicting when a spouse had negative perceptions of the abilities of the stroke survivors. Conclusion: The findings add to the current understanding of self-management and role management with regard to how these are situated in everyday activities. Daily activities can help both spouses to reflect and understand about self-management, role management and comanagement in daily life. Moreover, observing stroke survivors in everyday situations provides professionals with concrete pictures of stroke survivors' performance and self-management in interaction with their spouses.
Narrative exposure therapy for posttraumatic stress disorder associated with repeated interpersonal trauma in patients with severe mental illness: a mixed methods design
Mauritz, MW ; Gaal, B.G.I. van ; Jongedijk, RA ; Schoonhoven, Lisette ; Nijhuis-van der Sanden, M.W.G. ; Goossens, P.
2016, Article / Letter to editor (European Journal of Psychotraumatology, vol. 7, (2016))Background: In the Netherlands, most patients with severe mental illness (SMI) receive flexible assertive community treatment (FACT) provided by multidisciplinary community mental health teams. SMI patients with comorbid posttraumatic stress disorder (PTSD) are sometimes offered evidence-based trauma-focused treatment like eye movement desensitization reprocessing or prolonged exposure. There is a large amount of evidence for the effectiveness of narrative exposure therapy (NET) within various vulnerable patient groups with repeated interpersonal trauma. Some FACT-teams provide NET for patients with comorbid PTSD, which is promising, but has not been specifically studied in SMI patients. Objectives: The primary aim is to evaluate NET in SMI patients with comorbid PTSD associated with repeated interpersonal trauma to get insight into whether (1) PTSD and dissociative symptoms changes and (2) changes occur in the present SMI symptoms, care needs, quality of life, global functioning, and care consumption. The second aim is to gain insight into patients' experiences with NET and to identify influencing factors on treatment results. Methods: This study will have a mixed methods convergent design consisting of quantitative repeated measures and qualitative semi-structured in-depth interviews based on Grounded Theory. The study population will include adult SMI outpatients (n = 25) with comorbid PTSD and receiving NET. The quantitative study parameters will be existence and severity of PTSD, dissociative, and SMI symptoms; care needs; quality of life; global functioning; and care consumption. In a longitudinal analysis, outcomes will be analyzed using mixed models to estimate the difference in means between baseline and repeated measurements. The qualitative study parameters will be experiences with NET and perceived factors for success or failure. Integration of quantitative and qualitative results will be focused on interpreting how qualitative results enhance the understanding of quantitative outcomes. Discussion: The results of this study will provide more insight into influencing factors for clinical changes in this population.
Myd & Eat: a multidisciplinary intervention for myotonic dystrophy regarding food intake and nutrition
Hees, S.G.M. van ; Knuijt, S. ; Dicke, H ; Satink, T. ; Raaphorst, J ; Groothuis, JT ; Cup, Edith
2017, Article / Letter to editor (Neuromuscular Disorders, vol. 27, (2017), pp. S181)
Multifaceted interventions are required to improve physical activity behaviour in hospital care: a meta-ethnographic synthesis of qualitative research
Koenders, N. ; Marcellis, L ; Nijhuis-van der Sanden, M.W.G. ; Satink, T. ; Hoogeboom, Th.
2021, Article / Letter to editor (Journal of Physiotherapy, vol. 67, iss. 2, (2021), pp. 115-123)Question: What are the views of patients, close relatives and healthcare professionals on physical activity behaviour in hospital care? Methods: A meta-ethnographic synthesis of qualitative studies was conducted with a lines-of-argument analysis. The methodological quality of included studies was evaluated using the Critical Appraisal Skills Programme (CASP) checklist. The lines of argument were synthesised and mapped in an existing theoretical model. The confidence of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation Confidence in Evidence from Reviews of Qualitative Research (GRADE-CERQual) approach. Results: Eleven studies were included and provided data from 290 participants (145 patients, 0 close relatives and 145 healthcare professionals). We have synthesised six lines of argument that explained the (intention of) physical activity behaviour of patients during their hospital stay: patients and healthcare professionals perceive benefits and risks of physical activity for patients' health (high confidence); physical activity gives a sense of freedom, confidence in recovery and mental wellbeing (high confidence); all healthcare professionals should offer timely and tailored physical activity promotion (high confidence); patient motivation to be physically active may be contingent upon encouragement (moderate confidence); family members can influence physical activity behaviour favourably or unfavourably (low confidence); and hospital culture has a negative influence on physical activity behaviour of patients (high confidence). Conclusions: Physical activity behaviour of patients during their hospital stay is a complex phenomenon with multiple interactions at the level of patients, healthcare professionals and hospital culture. Considering the results of this synthesis, multifaceted implementation strategies are needed to improve physical activity intention and behaviour of patients during their hospital stay. (C) 2021 Australian Physiotherapy Association. Published by Elsevier B.V.
Mixed methods evaluation of a self-management group programme for patients with neuromuscular disease and chronic fatigue
Veenhuizen, Y ; Satink, T. ; Graff, Maud ; Geurts, A.C.H. ; Groothuis, JT ; Engelen, B.G.M. van ; Nijhuis-van der Sanden, M.W.G. ; Cup, E.H.C.
2021, Article / Letter to editor (BMJ Open, vol. 11, iss. 8, (2021))Objective To obtain insight into experiences of patients with a neuromuscular disease and chronic fatigue and their healthcare professionals regarding content and delivery of a multidisciplinary outpatient self-management group programme to improve social participation. This will inform future implementation. Design A mixed method study alongside a randomised controlled trial. Setting University hospital, rehabilitation centre and community health centre. Participants 29 patients with a neuromuscular disease and chronic fatigue and 13 healthcare professionals participated in this mixed methods study. Intervention Multidisciplinary group programme, called Energetic, consisted of a 4 months intervention with weekly meetings and covered four modules: (1) individually tailored aerobic exercise training; (2) education about aerobic exercise; (3) self-management training in applying energy conservation strategies and (4) implementation and relapse prevention in daily life. Main measures Quantitative data were collected by a questionnaire measuring patients' (n=25, all completed the programme) satisfaction with the perceived results, content and delivery of the programme. Qualitative data were collected by individual and focus group interviews to gain insight in the experiences of patients (n=18), next of kin (n=2) and healthcare professionals (n=13) with facilitators and barriers to programme implementation. Results Patients were satisfied with the number and length of the sessions, the different modules and the therapists. Analysis of the interviews led to five themes: (1) the combination of modules makes a complete picture, (2) the programme is physically and mentally intensive, (3) the group setting is valuable, (4) small variations in delivery occur in different settings, (5) therapists are coaches. Suggestions for programme improvement include a combination of face to face and e-health, enhancement of therapists' skills in guiding group interventions and inclusion of more booster sessions to evaluate and maintain self-management competencies. Conclusions The Energetic programme could be implemented in different healthcare settings and group settings, and a combination of modules proved to be a facilitator for improving self-management.
Meten is weten – Steeds meer aandacht voor meten vanuit cliëntperspectief van de cliënt: de PRO-Ergo
van de Ven, L. ; Cup, Edith ; Wassink, D. ; Satink, T. ; Graff, Maud
2022, Article / Letter to editor (Ergotherapie Magazine, vol. 3, (2022), pp. 14-16)
Meet and eat, an interdisciplinary group intervention for patients with myotonic dystrophy about healthy nutrition, meal preparation, and consumption: a feasibility study
Hees, S.G.M. van ; Knuijt, S. ; Dicke, H ; Groothuis, JT ; Raaphorst, J ; Satink, T. ; Cup, Edith
2020, Article / Letter to editor (Disability and Rehabilitation, vol. 42, iss. 11, (2020), pp. 1561-1568)Purpose: To develop and evaluate an interdisciplinary group intervention for patients with myotonic dystrophy regarding healthy nutrition, meal preparation, and consumption, called Meet and Eat. Materials and methods: A design-based approach was used, exploring experiences and needs of patients with myotonic dystrophy and their next of kin. This resulted in a 4-week interdisciplinary outpatient group intervention to increase awareness and change behavior. In a mixed-method feasibility study this intervention was evaluated with participants and facilitators. Results: Participants reported on social impact of difficulties with eating and drinking (speaking, swallowing, and social embarrassment) and a variety of complaints affecting meal preparation and consumption. Patients and family members expressed the wish to learn from others. After delivery of the intervention, self-reported outcome measures demonstrated improvement on eating and drinking issues in daily life. The qualitative evaluation showed increased awareness and appreciation of the following design principles: peer support, multidisciplinary approach, active involvement of patient with myotonic dystrophy and their next of kin by using personal goals and motivational interviewing. Conclusion: Participation in Meet and Eat seemed to increase insight in patients' condition and ways of management. However, a longer self-management life style program is recommended to change behavior.
Maximum Repetition Rate in a large cross-sectional sample of typically developing Dutch-speaking children
Diepeveen, S.J.H. ; Haaften, L van ; Terband, H ; Swart, B.J.M. de ; Engel-Hoek, Lenie van den ; Maassen, B
2021, Article / Letter to editor (International Journal of Speech-Language Pathology, vol. 23, iss. 5, (2021), pp. 508-518)
Maatschappijgerichte ergotherapie: What’s in the name?
Minis, Marie-Antoinett van ; Satink, T.
2011, Article / Letter to editor (Wetenschappelijk Tijdschrift voor Ergotherapie, vol. 4, iss. 3, (2011), pp. 60-63)In deze column zullen wij stilstaan bij het concept CBOT, en de concepten ‘community’ en ‘occupation’. We hopen met deze column een discussie op gang te brengen over een nieuwe ontwikkeling in Nederland en aan te geven hoe belangrijk het is om (vertaalde) concepten goed te definiëren.
Living with myotonic dystrophy; what can be learned from couples? a qualitative study
Cup, Edith ; Kinebanian, A ; Satink, T. ; Pieterse, AJ ; Hendricks, HT ; Oostendorp, Rob ; Wilt, GJ van der ; Engelen, B.G.M. van
2011, Article / Letter to editor (BMC Neurology, vol. 11, (2011))Background: Myotonic dystrophy type 1 (MD1) is one of the most prevalent neuromuscular diseases, yet very little is known about how MD1 affects the lives of couples and how they themselves manage individually and together. To better match health care to their problems, concerns and needs, it is important to understand their perspective of living with this hereditary, systemic disease. Methods: A qualitative study was carried out with a purposive sample of five middle-aged couples, including three men and two women with MD1 and their partners. Fifteen in-depth interviews with persons with MD1, with their partners and with both of them as a couple took place in the homes of the couples in two cities and three villages in the Netherlands in 2009. Results: People with MD1 associate this progressive, neuromuscular condition with decreasing abilities, describing physical, cognitive and psychosocial barriers to everyday activities and social participation. Partners highlighted the increasing care giving burden, giving directions and using reminders to compensate for the lack of initiative and avoidant behaviour due to MD1. Couples portrayed the dilemmas and frustrations of renegotiating roles and responsibilities; stressing the importance of achieving a balance between individual and shared activities. All participants experienced a lack of understanding from relatives, friends, and society, including health care, leading to withdrawal and isolation. Health care was perceived as fragmentary, with specialists focusing on specific aspects of the disease rather than seeking to understand the implications of the systemic disorder on daily life. Conclusions: Learning from these couples has resulted in recommendations that challenge the tendency to treat MD1 as a condition with primarily physical impairments. It is vital to listen to couples, to elicit the impact of MD1, as a multisystem disorder that influences every aspect of their life together. Couple management, supporting the self-management skills of both partners is proposed as a way of reducing the mismatch between health services and health needs.
Literatuurstudie van de constraint-induced movement therapy en implicaties voor de praktijk
Bosmans, Juliette ; Minis, Marie-Antoinett van ; Steultjens, E.M.J. ; Swart, B.J.M. de
2012, Article / Letter to editor (Wetenschappelijk Tijdschrift voor Ergotherapie, vol. 2012, iss. 2, (2012), pp. 33-46)De Constraint-Induced Movement Therapy (CIMT) is een behandelmethode in de neurorevalidatie die erop gericht is om het gHet primaire doel van deze literatuurstudie is te achterhalen of de CIMT en de modified-CIMT (mCIMT) valide en effectieve behandelmethoden zijn om de armen handfunctie van de paretische zijde in de subacute en chronische fase na een CVA te verbeteren. De secundaire doelen zijn het onderzoeken van de effecten van de CIMT en mCIMT op het verbeteren van de uitvoer van dagelijkse activiteiten en participatie.ebruik van de paretische arm en hand na een Cerebro Vasculair Accident (CVA) te verbeteren.
Kennisdomein van de ergotherapie
Satink, T. ; Kos, D. ; Velde, D. van der
2022, Part of book or chapter of book (van Hartingsveldt, M.; Kos, D.; le Granse, M. (ed.), Grondslagen van de ergotherapie)
Investigating the Efficacy and Experiences With Narrative Exposure Therapy in Severe Mentally Ill Patients With Comorbid Post-traumatic Stress Disorder Receiving Flexible Assertive Community Treatment: A Mixed Methods Study
Mauritz, M ; Goossens, P. ; Jongedijk, R ; Vermeulen, H. ; van Gaal, B
2022, Article / Letter to editor (Frontiers in Psychiatry, vol. 13, (2022))Background: Patients with severe mental illness with repeated interpersonal trauma and post-traumatic stress disorder (PTSD) have a negative illness progression. Traumas are often not treated because of their vulnerability. Narrative exposure therapy (NET) is an effective trauma therapy. It is unknown whether NET is effective and tolerable in these patients receiving community mental healthcare. Objectives: The objectives of this study are (1) to gain insights into patients' experiences before, during, and after NET concerning changes in PTSD, dissociative and severe mental ill symptoms, care needs (CAN), quality of life, and global functioning; (2) to identify factors that influence diagnostic changes after NET as compared to patients' experiences. These insights will help to decide whether NET should be incorporated in usual care for these patients. Design: A mixed methods convergent design consists of a grounded theory approach with thematic analysis followed by a merged analysis, comparing quantitative, and qualitative data for each participant and by means of a joint matrix. Participants: Adult psychiatric outpatients (age, 21-65) with post-traumatic stress disorder (PTSD) related to repeated interpersonal trauma were indicted for the study. Methods: Baseline demographics and clinical characteristics were assessed. Qualitative data were collected 3 months after NET using individual semi-structured in-depth interviews. The merged analysis compared quantitative and qualitative results for each participant. Results: Twenty-three outpatients (female, 82%) with a mean age of 49.9 years (SD 9.8) participated in the study. Participants experienced NET as intensive, and most of them tolerated it well. Afterward, eighteen participants perceived less symptoms. Mixed analysis showed substantial congruency between quantitative scores and participants' perceptions of PTSD, dissociative symptoms, and CAN (Cohen's kappa > 0.4). Remission of PTSD was associated with sufficient experienced support. Conclusion: Outpatients with severe mental illness underwent intensive NET, and most of them tolerate it well. This therapy is clearly efficacious in this group.
Interrater Reliability of the Observable Movement Quality Scale for Children.
Dekkers, L.M.A. ; Nijhuis-van der Sanden, M.W.G. ; Jonker, M. ; Swart, B.J.M. de ; Janssen, Astrid
2018, Article / Letter to editor (Physiotherapy Canada, vol. 70, iss. 2, (2018), pp. 113-119)
Individual longitudinal neurodevelopmental trajectories of children treated with hypothermia for perinatal asphyxia from 3 months to 5 years of age
Dekkers, L.M.A. ; Janssen, A. ; Steiner, K. ; Maas-van Schaijk, N. ; Akkermans, R. ; de Swart, B. ; Nijhuis-vander Sanden, M.
2020, Article / Letter to editor (Research in Developmental Disabilities, vol. 102, (2020))
Implementation and process evaluation of the energetic study
Veenhuizen, Y ; Cup, Edith ; Satink, T. ; Groothuis, JT ; Engelen, B.G.M. van ; Nijhuis-van der Sanden, M.W.G. ; Guerts, A
2016, Article / Letter to editor (Neuromuscular Disorders, vol. 26, (2016), pp. S147-S148)
Impact of COVID-19 Pandemic on Young Children With Feeding and Eating Problems and Disorders and Their Families.
Krom, H. ; Mameren, J. van ; Remijn, L. ; Nennie, K. de ; Dumont, E. ; Gaag, E. van der ; Leeuwen, M.C.C. van ; Mulkens, S. ; Schakelaar, C. ; Kindermann, A
2022, Article / Letter to editor (Journal of Pediatric Gastroenterology and Nutrition, vol. 75, iss. 4, (2022), pp. 529-534)OBJECTIVES: The incidence of feeding and eating problems and disorders (FEPD) in children increased during the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to assess the impact of the COVID-19 pandemic on young children with FEPD and their parents. METHODS: Cross-sectional survey: parents of children with FEPD (0-11 years) in the Netherlands completed an online questionnaire (January-April 2021). This questionnaire included 4 demographic questions (including criteria of pediatric feeding disorder [PFD] and/or avoidant/restrictive food intake disorder [ARFID]) and 11 questions related to experienced impact of the COVID-19 pandemic. Parental responses regarding children with FEPD (including PFD and ARFID) were compared with those of healthy controls (HCs). RESULTS: In total, 240 children (median age, 5.5 years; interquartile range [IQR], 3.5-7.9 years; 53.3% female) were included; 129 children with FEPD and 111 HC. Most children with FEPD fulfilled criteria for PFD (n = 119; 92.2%) and/or ARFID (n = 117; 90.7%). Parents of children with FEPD reported more stress (of their child [ P = 0.014] and parental stress [ P = 0.014]), worse eating by the child ( P < 0.001), more negative relations within the family ( P = 0.006), and less support from the environment ( P = 0.001) compared with parents of HC during the COVID-19 pandemic than before. CONCLUSIONS: It seems that the COVID-19 pandemic had great impact on young children with FEPD and their parents because parents of children with FEPD reported significantly more perceived stress within both the child and parents, more difficult eating behavior of the child, more negative behavior between family members, and less support from the environment as compared with HC.
Identifying the minimal important difference in patient-reported outcome measures in the field of people with severe mental illness: a pre-post-analysis of the Illness Management and Recovery Programme
Beentjes, T.A.A. ; Teerenstra, S. ; Vermeulen, H. ; Goossens, P. ; Nijhuis-van der Sanden, M.W.G. ; Gaal, B.G.I. van
2021, Article / Letter to editor (Quality of Life Research, (2021))Purpose Complementary interventions for persons with severe mental illness (SMI) focus on both personal recovery and illness self-management. This paper aimed to identify the patient-reported outcome measures (PROMs) associated with the most relevant and meaningful change in persons with SMI who attended the Illness Management and Recovery Programme (IMR). Methods The effect of the IMR was measured with PROMs concerning recovery, illness self-management, burden of symptoms and quality of life (QoL). From the QoL measures, an anchor was chosen based on the most statistically significant correlations with the PROMs. Then, we estimated the minimal important difference (MID) for all PROMs using an anchor-based method supported by distribution-based methods. The PROM with the highest outcome for effect score divided by MID (the effect/MID index) was considered to be a measure of the most relevant and meaningful change. Results All PROMs showed significant pre-post-effects. The QoL measure 'General Health Perception (Rand-GHP)' was identified as the anchor. Based on the anchor method, the Mental Health Recovery Measure (MHRM) showed the highest effect/MID index, which was supported by the distribution-based methods. Because of the modifying gender covariate, we stratified the MID calculations. In most MIDs, the MHRM showed the highest effect/MID indexes. Conclusion Taking into account the low sample size and the gender covariate, we conclude that the MHRM was capable of showing the most relevant and meaningful change as a result of the IMR in persons with SMI.
How the Illness Management and Recovery Program Enhanced Recovery of Persons With Schizophrenia and Other Psychotic Disorders: A Qualitative Study
Langen, W.J.M. van ; Beentjes, T.A.A. ; Gaal, B.G.I. van ; Nijhuis-van der Sanden, M.W.G. ; Goossens, P.
2016, Article / Letter to editor (Archives of Psychiatric Nursing, vol. 30, iss. 5, (2016), pp. 552-557)This study aims to describe how the Illness Management and Recovery program enhanced recovery of persons with schizophrenia and other psychotic disorders from their own perspective. Participants valued learning how to divide huge goals into attainable steps, how to recognize and prevent a relapse by managing symptoms, practicing skills, and talking openly about illness related experience. They learned from the exchange with peers and from the information in the IMR textbook. Nurses should have continuous attention and reinforcement for progress on goals, skills practice and exchange of peer information. A peer-support specialist can contribute to keep this focus. (C) 2016 Elsevier Inc. All rights reserved.
How Persons with a Neuromuscular Disease Perceive Employment Participation : A Qualitative Study
Minis, Marie-Antoinett van ; Satink, T. ; Kinébanian, Astrid ; Engels, J.A. ; Heerkens, Y.F. ; Engelen, B.G.M. van ; Nijhuis-van der Sanden, M.W.G.
2014, Article / Letter to editor (Journal of Occupational Rehabilitation, vol. 24, iss. 1, (2014), pp. 52-67)Introduction A qualitative study was carried out to understand how people with a slow progressive adult type neuromuscular disease (NMD) perceive employment participation. Methods 16 paid employed persons with NMD were interviewed in open, in-depth interviews. Data were analyzed using the constant comparison method. Results Four themes were identified in the analyses: (1) Experiences regarding the meaning of work; (2) Solving problems oneself; (3) Reaching a turning point; and (4) Taking into account environmental aspects. Persons with NMD highlighted benefits of staying at work as well as the tension they felt how to shape decisions to handle progressive physical hindrances in job retention. This study shows how participants at work with NMD were challenged to keep up appearances at work and at home, the tension felt around when and if to disclose, the effect of their condition on colleagues and work reorganization challenges. Participants experienced that disclosure did not always make things better. With increasing disability participants’ focus shifted from the importance of assistive products towards considerate colleague, in particular superior’s willingness in supporting job retention.
How is self-management perceived by community living people after a stroke? A focus group study
Satink, T. ; Cup, Edith ; Swart, B.J.M. de ; Nijhuis-van der Sanden, M.W.G.
2015, Article / Letter to editor (Disability and Rehabilitation, vol. 37, iss. 3, (2015), pp. 223-230)Purpose: Self-management has become an important concept in stroke rehabilitation; however, the way that people post-stroke reflect on the concept of self-management has not yet been studied. This qualitative study explored the reflections of persons post-stroke on self-management, readiness and needs in self-management support. Methods: Focus group interviews were conducted with 16 community living stroke survivors (53-84 years of age). Both verbal questions and photo elicitations were used to collect data. A constant comparative framework was used for the analysis. Result: Participants described their self-management as a complex, long-term, personal learning process. Post-discharge, participants were not ready to self-manage. Aside from individual self-management, participants also mentioned co-management with relatives. Relatives could provide support, but they also limited the development of participants' self-management skills. Participants missed having professional support post-discharge and would have appreciated additional psychological and emotional support in their process of self-management. Conclusion: Self-management post-stroke is complex. Stroke self-management programmes may be optimised when integrating role and emotional management in addition to medical management. Although readiness to self-manage differs among individuals, support should start as soon as possible and continue post-discharge in people's personal environments. Self-management programmes should not only focus on self-management of stroke survivors but also on co-management with relatives.
How do healthcare professionals experience communication with people with aphasia and what content should communication partner training entail?
van Rijssen, M.N. ; Veldkamp, M ; Byron, E ; Remijn, C.S.M. ; Visser-Meily, J.M.A ; Gerrits, E ; Ewijk, L
2022, Article / Letter to editor (Disability and Rehabilitation, vol. 44, iss. 14, (2022), pp. 3671-3678)
How do community based dementia friendly initiatives work for people with dementia and their caregivers, and why? A rapid realist review
Thijssen, M.C.E. ; Daniels, R. ; Lexis, M. ; Jansens, R. ; Peeters, J. ; Chadborn, N. ; Nijhuis-van der Sanden, M.W.G. ; Graff, Maud
2021, Article / Letter to editor (International Journal of Geriatric Psychiatry, vol. 2021, (2021), pp. 1-14)
How chronic pain changes a person's life story in relation to participation in occupational roles: A narrative exploration
Strub, P ; Satink, T. ; Gantschnig, BE
2021, Article / Letter to editor (Scandinavian Journal of Occupational Therapy, (2021))Background Chronic pain (CP) affects a large part of the population worldwide, decreasing physical and mental health and causing a shift in occupational roles. This has created a need for a better understanding to address this problem. Objectives To explore possible changes in occupational roles and the participation levels within among people diagnosed with CP over time. Material and methods The study used a qualitative, narrative methodology. Five people with CP were included in the study. They participated in a single-life story interview coupled with timeline drawings. Data analysis was conducted using a narrative analysis. Results The results revealed that occupational roles and the participation therein changed over time. Employee was considered the most important role, whereby the participants tried to maintain this role by sacrificing other roles within their lives. Moreover, CMP forced a change in their occupational identity. Conclusion CP can disrupt a person's life and demand a change in occupational roles and the participation levels within. This process was accompanied by possible changes in their occupational identity.
Hoofdstuk 28: Ergotherapie
Lindenschot, M. ; Rijnbeek, D. ; Satink, T. ; Nijhuis-van der Sanden, M.W.G.
2017, Part of book or chapter of book (Spaans, J; van der Horst, H.; Visser, S. (ed.), Handboek behandeling van somatisch onvoldoende verklaarde lichamelijke klachten)
Hoe ga je in gesprek met kinderen over de betekenis van hun handelen?
Schot, M. ; Lindenschot, M. ; Velde, A.
2020, Article / Letter to editor (Ergotherapie Magazine, vol. 5, (2020), pp. 40-44)
Healthcare needs, expectations, utilization, and experienced treatment effects in patients with hereditary spastic paraplegia: a web-based survey in the Netherlands
Kerstens, H.C.J.W. ; Lith, B.J.H. van ; Nijkrake, M.J. ; Swart, B.J.M. de ; Bemd, LAC van den ; Smeets, RJEM ; Klemens, F ; Warrenburg, BPC van de ; Wees, P.J. van der ; Geurts, A.C.H.
2021, Article / Letter to editor (Orphanet Journal of Rare Diseases, vol. 16, iss. 1, (2021))Background We aimed to identify healthcare needs, expectations, utilization, and the experienced treatment effects in a population of Dutch patients with hereditary spastic paraplegia (HSP). Methods We distributed an online questionnaire among 194 adult persons with HSP in the Netherlands, of which 166 returned a fully completed version. After applying predefined exclusion criteria, 109 questionnaires from persons with pure HSP were analysed. Results Healthcare needs and expectations were primarily focused on the relief of muscle stiffness and reduction of balance and gait impairments (65-80%), but many participants also expressed needs regarding relief of non-motor symptoms (e.g. pain, fatigue), emotional problems, impaired sleep and self-care capacity, and participation problems (> 60%). Remarkably, despite these frequent needs, relatively few participants (< 33%) expected to be able to improve in these additional domains. Rehabilitation physicians and physiotherapists were more frequently consulted than neurologists and occupational therapists, respectively. Physiotherapy was the most often proposed non-pharmacological intervention (85%), followed by orthopedic footwear (55%) and splints (28%). Approximately one third of the participants was never offered any pharmacological (spasmolytic) treatment. Spasmolytic oral drugs, injections, and intrathecal baclofen were given to 41%, 26%, and 5% of the participants, respectively. Independent of the type of pharmacological intervention, 35-46% of these participants experienced decreased spastiticy and improved general fitness. Other experienced effects differed per type of intervention. Conclusions Based on this web-based survey in the Netherlands, there seems to be ample room for improvement to meet and attune the healthcare needs and expectations of people with HSP concerning both their motor and non-motor symptoms and functional limitations. In addition, the provision of adequate information about non-pharmacological and pharmacological interventions seems to be insufficient for many patients to allow shared decision making. These conclusions warrant a more pro-active attitude of healthcare providers as well as an interdisciplinary approach for a substantial proportion of the HSP population, also involving professionals with a primary occupational and/or psychosocial orientation.
Health professionals' experiences with the PEDI-UG: What doUgandan occupational therapists say about the utility andvalue of the Pediatric Evaluation of Disability Inventory(PEDI-UG) for children with disabilities?
Ekwan, F. ; Schulze, C. ; Kamwesiga, T. ; Satink, T.
2022, Article / Letter to editor (Child: Care, Health and Development, (2022), pp. 1-8)
Health professionals' experiences with the PEDI-UG: What do Ugandan occupational therapists say about the utility and value of the Pediatric Evaluation of Disability Inventory (PEDI-UG) for children with disabilities?
Ekwan, F. ; Satink, T. ; Kamwesiga, J. ; Schulze, C.
2022, Article / Letter to editor (Child: Care, Health and Development, (2022))BACKGROUND: The Uganda version of Pediatric Evaluation of Disability Inventory (PEDI-UG) was culturally adapted and validated from the PEDI-US, a tool used to evaluate the functional capability of children with or without disability aged 6 months to 7.5 years in the areas of self-care, mobility and social domains. A group of Ugandan occupational therapists with experience of using PEDI-UG participated in this study to explore the question: What do Ugandan occupational therapists say about the utility and value of the PEDI-UG for children with disabilities? METHODS: A qualitative research design was chosen to explore the participants' viewpoints concerning the utility and value of the PEDI-UG for children with disabilities. Purposive sampling was used to recruit health professionals for the focus group discussions. Focus group discussions were carried out with 18 occupational therapists and nurses. Thematic analysis was performed to establish patterns and themes. RESULTS: Several challenges concerning the contextual use of PEDI-UG were reported. For example, PEDI-UG being culturally adapted in two languages (English and Luganda) makes it difficult for health professionals to use it for children whose caregivers are non-English or non-Luganda speakers. In addition, participants reported adapting the way they asked the assessment questions, struggling with how they interpreted the scores and observing the child's skills if required during PEDI-UG interviews with caregivers. CONCLUSIONS: The findings of this study suggest that health professionals are challenged with the use of the PEDI-UG assessment in diverse cultural contexts and/or languages. These challenges are important considerations for the PEDI-UG translation in different Uganda cultural languages and training health professionals on the use and value of PEDI-UG for children with disabilities.
Hand motor skills affect the intake of finger foods in toddlers (12–18 months)
Remijn, C.S.M. ; da Costa, SP ; Bodde, C ; Gerdink, R ; Weenen, H ; Vereijken, C ; Schans, C. van der
2019, Article / Letter to editor (Food Quality and Preference, vol. 74, iss. june, (2019), pp. 142-146)
Gezondheid, Welzijn en Participatie
Arts-Tielemans, M. ; Satink, T. ; van der Velde, D.
2022, Part of book or chapter of book (van Hartingsveldt, M.; Kos, D.; le Granse, M. (ed.), Grondslagen van de ergotherapie)
Fopspeengebruik, duim-en vingerzuigen en malocclusie
Hollaar, V.R.Y. ; Remijn, C.S.M.
2020, Article / Letter to editor (Nederlands Tijdschrift voor Mondhygiëne, vol. 26, iss. 1, (2020), pp. 14-16)
Exposure to texture of foods for 8-month-old infants: Does the size of the pieces matter?
Costa, S.P. da ; Remijn, L. ; Weenen, H ; Vereijken, C ; Schans, C. van der
2017, Article / Letter to editor (J Texture Stud, vol. 48, iss. 6, (2017), pp. 534-540)This study examined the effect of meals varying in amount, size, and hardness of food pieces on the development of the chewing capabilities of 8-month-old infants. The study also examined changes in shivering, gagging, coughing, choking, and their ability to eat from a spoon. In an in-home setting two groups were given commercially available infant meals and fruits, purees with either less, smaller and softer or more, larger and harder pieces. Both groups were given these foods for 4 weeks and were monitored several times during this period. After the 4-week exposure period infants in both groups were given the same five test foods. Structured questionnaires with questions on eating behavior and the child's development were conducted 6 times in the 4 to 12-month period and video analyses of feedings were conducted 4 times between 8 and 9 months. After the 4-week exposure period, the group that had been exposed to the foods with more, larger and harder pieces showed a significantly higher rating for chewing a piece of carrot and potato for the first time, but not for a piece of banana nor for mashed foods. Shivering, gagging, coughing, choking, and ability to eat from a spoon were not different between the two groups. These results contribute to the insight that exposure to texture is important for young children to learn how to handle texture. PRACTICAL APPLICATIONS: (a) The study shows the feasibility of testing the effects of texture interventions on chewing capability and oral responses such as gagging, coughing, and choking in infants. (b) The study contributes to the insight that exposure to food texture to learn how to handle texture is important for infants and showed that exposing children to a higher amount of larger pieces improves their chewing capability for a piece of carrot and potato, at least immediately after the intervention.
Exploring the collaboration between formal and informal care from the professional perspectiveA thematic synthesis
Hengelaar, AH ; Hartingsveldt, Margo van ; Wittenberg, Y ; Etten-Jamaludin, F van ; Kwekkeboom, R ; Satink, T.
2018, Article / Letter to editor (Health & Social Care in the Community, vol. 26, iss. 4, (2018), pp. 474-485)In Dutch policy and at the societal level, informal caregivers are ideally seen as essential team members when creating, together with professionals, co-ordinated support plans for the persons for whom they care. However, collaboration between professionals and informal caregivers is not always effective. This can be explained by the observation that caregivers and professionals have diverse backgrounds and frames of reference regarding providing care. This thematic synthesis sought to examine and understand how professionals experience collaboration with informal caregivers to strengthen the care triad. PubMed, Medline, PsycINFO, Embase, Cochrane/Central and CINAHL were searched systematically until May 2015, using specific key words and inclusion criteria. Twenty-two articles were used for thematic synthesis. Seven themes revealed different reflections by professionals illustrating the complex, multi-faceted and dynamic interface of professionals and informal care. Working in collaboration with informal caregivers requires professionals to adopt a different way of functioning. Specific attention should be paid to the informal caregiver, where the focus now is mainly on the client for whom they care. This is difficult to attain due to different restrictions experienced by professionals on policy and individual levels. Specific guidelines and training for the professionals are necessary in the light of the current policy changes in the Netherlands, where an increased emphasis is placed on informal care structures.

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