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.
2010, Part of book or chapter of book (, pp. 23-38)Deze bijdrage is een verkorte versie van de intreerede die dr. R.M. Verburg op 24 oktober heeft gehouden bij de aanvaarding van zijn ambt als lector HRM aan de Hogeschool van Arnhem en Nijmegen (HAN). Het ontwikkelen van een effectief personeelsbestand is geen eenvoudige taak. Personeelsmanagers worden steeds vaker geconfronteerd met vragen om het personeelsbeleid te herzien om meer toegevoegde waarde te creëren. Ook worden lijnmanagers steeds meer betrokken bij personeelsbeslissingen, zoals werving, selectie en ontwikkeling van nieuw personeel. In dit artikel worden de eerste ideeën met betrekking tot Human Resource Management (HRM) op het gebied van wetenschappelijk onderzoek behandeld, vervolgens wordt ingegaan op de recente uitdagingen in het veld zoals de link met kennismanagement en innovatie en de daarmee verbonden betekenis hiervan op de huidige praktijk van personeelsmanagement.
2021, Article / Letter to editor (Temperature, vol. 8, iss. 3, (2021), pp. 209-222)The environmental conditions during the Tokyo Olympic and Paralympic Games are expected to be challenging, which increases the risk for participating athletes to develop heat-related illnesses and experience performance loss. To allow safe and optimal exercise performance of Dutch elite athletes, the Thermo Tokyo study aimed to determine thermoregulatory responses and performance loss among elite athletes during exercise in the heat, and to identify personal, sports-related, and environmental factors that contribute to the magnitude of these outcomes. For this purpose, Dutch Olympic and Paralympic athletes performed two personalized incremental exercise tests in simulated control (15°C, relative humidity (RH) 50%) and Tokyo (32°C, RH 75%) conditions, during which exercise performance and (thermo)physiological parameters were obtained. Thereafter, athletes were invited for an additional visit to conduct anthropometric, dual-energy X-ray absorptiometry (DXA), and 3D scan measurements. Collected data also served as input for a thermophysiological computer simulation model to estimate the impact of a wider range of environmental conditions on thermoregulatory responses. Findings of this study can be used to inform elite athletes and their coaches on how heat impacts their individual (thermo)physiological responses and, based on these data, advise which personalized countermeasures (i.e. heat acclimation, cooling interventions, rehydration plan) can be taken to allow safe and maximal performance in the challenging environmental conditions of the Tokyo 2020 Olympic and Paralympic Games.
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.
2012, External research report Deze handleiding is het product van een afstudeeropdracht van studenten Toegepaste Psychologie van de Hogeschool van Arnhem en Nijmegen. De handlediing is ontwikkeld i.s.m. de RIBW, NITransition, San Diego State University en het Lectoraat Levensloopbegeleiding bij Autisme (HAN). De handleiding beschrijft verschillende benaderingen van Person Centered Planning (PCP) en bevat een concreet plan voor de uitvoering van PCP. De handleiding is oorspronkelijk bedoeld voor professionals in de zorg voor mensen met autisme spectrum stoornissen (ASS), maar kan door iedereen gebruikt worden die aan de slag wil met een beproefde planningsmethodiek.
2010, Part of book or chapter of book (, pp. 52-53)Liber amicorum voor Peter Koopman: ter gelegenheid van zijn afscheid van Dimence uitgereikt op 12 april 2010
2014, Article / Letter to editor (Teaching in Higher Education, vol. 19, iss. 7, (2014), pp. 799-811)Many factors play a role in the successful transition of students from secondary to university education: one of them is the (university) teacher. In this study the similarities and differences in the perspectives on teaching and learning of secondary and university teachers were investigated. A survey was performed among 675 teachers. Three perspectives on teaching and learning could be distinguished: (1) a development orientation with shared regulation, (2) a knowledge orientation with strong regulation, and (3) an opinion orientation with loose regulation. Secondary teachers scored higher on the first perspective than university teachers who scored higher on the third perspective. These findings have implications for the transition of students from pre-university to university education and especially for teachers' roles.
2013, Article / Letter to editor (Physical Therapy, vol. 93, iss. 4, (2013), pp. 514-528)BACKGROUND: The treatment-related burden for patients undergoing hematopoietic stem cell transplantation (HSCT) may be relieved by physical exercises. PURPOSE: The purpose of this study was to summarize and analyze the evidence provided by randomized controlled trials (RCTs) on physical exercise interventions among patients with cancer undergoing HSCT. DATA SOURCES: PubMed, CINAHL, EMBASE, the Cochrane Library, and PEDro were searched for relevant RCTs up to October 1, 2011. STUDY SELECTION: Two reviewers screened articles on inclusion criteria and indentified relevant RCTs. DATA EXTRACTION: Two authors assessed the selected articles for risk of bias. Data extraction was performed by 1 reviewer. Meta-analyses were undertaken to estimate the outcomes quality of life (QOL), psychological well-being and distress, and fatigue. DATA SYNTHESIS: Eleven studies were included, with study populations consisting of recipients undergoing either an allogeneic or autologous HSCT (n=734). Four studies had low risk of bias. The exercise interventions were performed before, during, and after hospitalization for the HSCT. Different exercise programs on endurance, resistance and/or activities of daily living training, progressive relaxation, and stretching were used. Meta-analyses showed that exercise during hospitalization led to a higher QOL (weighted mean difference=8.72, 95% confidence interval=3.13, 14.31) and less fatigue (standardized mean difference=0.53, 95% confidence interval=0.16, 0.91) in patients with an allogeneic HSCT at the moment of discharge from the hospital. No marked effects were found for psychological well-being and distress. Individual study results suggested significant positive effects on QOL, fatigue, psychological well-being and distress, and physical functioning. LIMITATIONS: Prevalent shortcomings in the included studies were the heterogeneity among studies and the lack of blinding of participants, personnel, and outcome assessment. CONCLUSIONS: The results suggest that recipients of HSCT may benefit from physical exercise.
2018, Article / Letter to editor (Physiotherapy Theory and Practice, vol. 34, iss. 10, (2018), pp. 747-756)PURPOSE: This study explores the feasibility and preliminary effectiveness of an exercise program in people scheduled for hematopoietic stem cell transplantation (HSCT). METHODS: In this controlled clinical trial, we compare pre-transplantation exercise to no exercise in the waiting period for an allogeneic of autologous HSCT. The supervised individually tailored exercise program (4-6 weeks) consisted of aerobic endurance, muscle strength, and relaxation exercises, administered twice a week in the period prior to HSCT. Feasibility was determined based on inclusion rate, attrition rate, adherence to intervention, safety, and satisfaction (0-10). Preliminary effectiveness was determined primarily by self-perceived physical functioning, quality of life (QOL), and fatigue. Secondary outcomes were global perceived effect (GPE), blood counts, hospital stay, and physical fitness. RESULTS: Forty-six patients were eligible, of whom 29 (69%) participated: 14 in the intervention group and 15 in the control group. The adherence rate to training was 69%. No adverse events or injuries occurred. Satisfaction of training conditions was high (mean 9.2 ±1.3). Positive (follow-up) trends in favor of the intervention group were found for self-perceived physical functioning, QOL, fatigue, GPE, blood counts, and hospital stay. CONCLUSION: Exercise prior to HSCT is safe and feasible, and positive trends suggest favorable preliminary effectiveness. Adherence to the exercise program needs to be optimized in a future trial.
2017, Article / Letter to editor (BMC Musculoskeletal Disorders, vol. 18, iss. 1, (2017), pp. 196)BACKGROUND: Musculoskeletal disorders are a major health problem resulting in negative effects on wellbeing and substantial costs to society. Work participation is associated with positive benefits for both mental and physical health. Potentially, generalist physical therapists (GPTs) can play an important role in reducing absenteeism, presenteeism and associated costs in patients with musculoskeletal disorders. However, work participation is often insufficiently addressed within generalist physical therapy practice (GPTP). Therefore, this study evaluates whether GPTs take work participation into account as a determining factor in patients with musculoskeletal disorders, and how this might be improved. METHODS: This qualitative study consisted of seven focus groups involving 30 participants: 21 GPTs and 9 occupational physical therapists (OPTs). Based on an interview guide, participants were asked how they integrate work participation within their practice, how they collaborate with other professionals, and how GPTs can improve integration of the patient's work within their practice. RESULTS: Although participants recognized the importance of work participation, they mentioned that the integration of this item in their GPTP could be improved. Generally, GPTs place insufficient priority on work participation. Moreover, there is a lack of cooperation between the generalist physical therapist and (other) occupational healthcare providers (including OPTs), and the borderlines/differences between generalist physcial therapy and occupational health physcial therapy were sometimes unclear. GPTs showed a lack of knowledge and a need for additional information about several important work-related factors (e.g. work content, physical and psychosocial working conditions, terms of employment). CONCLUSIONS: Although a patient's work is important, GPTs take insufficient account of work participation as a determining factor in the treatment of patients with musculoskeletal disorders. GPTs often lack specific knowledge about work-related factors, and there is insufficient cooperation between OPTs and other occupational healthcare providers. The integration of work participation within GPTP, and the cooperation between GPTs and other occupational healthcare providers, show room for improvement.
1994, Article / Letter to editor (Jom. Journal of Occupational Medicine, vol. 36, iss. 3, (1994), pp. 338-345)A study was conducted to investigate the physical work load and the prevalence of musculoskeletal complaints of nurses in nursing homes. Thirty-six female subjects selected from three nursing homes in the Netherlands participated in an observational study. In addition, the total nursing staff (n = 668) was invited to take part in a questionnaire survey (response was 94%). It was noticed that almost 60% of the observed time was spent on nonpatient-related activities. Moreover, activities alternated rapidly and seldom lasted longer than 4 minutes on average. Twenty percent of the observed time was spent in "poor" work postures as defined by the Ovako Working Posture Analyzing System (Action Category 2 to 4). Activities contributing most to these poor work postures were patient care and household and preliminary tasks. Perceived exertion as scored on the Borg-CR10 scale was highest during patient-related activities. This holds also for a relative increase of heart rate. Questionnaire results showed prevalences of 41%, 35%, and 20% respectively, for back, arm/neck, and leg complaints. From this study it can be concluded that not only patient-related activities should be taken into consideration for the improvement of work postures and other potential strenuous aspects of nursing work. Household and preliminary tasks, ergonomic layout of the ward, and work pressure also deserve attention.
2019, Article / Letter to editor (Tijdschrift voor Psychiatrie, vol. 61, iss. februari 2019, (2019), pp. 81-83)https://www.napa.nl/2019/02/opinieartikel-in-de-psychiater-over-pa-binnen-ggz/
2016, Article / Letter to editor (Journal of Evaluation in Clinical Practice, vol. 22, iss. 3, (2016), pp. 395-402)Rationale, aims and objectivesMedical ward care has been increasingly reallocated from medical doctors (MDs) to physician assistants (PAs). Insight into their roles and tasks is limited. This study aims to provide insight into different organizational models of medical ward care, focusing on the position, tasks and responsibilities of the involved PAs and MDs. MethodsIn this cross-sectional descriptive study 34 hospital wards were included. Characteristics of the organizational models were collected from the heads of departments. We documented provider continuity by examination of work schedules. MDs and PAs in charge for medical ward care (n=179) were asked to complete a questionnaire to measure workload, supervision and tasks performed. ResultsWe distinguished four different organizational models for ward care: medical specialists in charge of admitted patients (100% MS), medical residents in charge (100% MR), PAs in charge (100% PA), both MRs and PAs in charge (mixed PA/MR). The wards with PAs had the highest provider continuity. PAs spend relatively more time on direct patient care; MDs spend relatively more time on indirect patient care. PAs spend more hours on quality projects (P=0.000), while MDs spend more time on scientific research (P=0.030). ConclusionAcross different organizational models for medical ward care, we found variations in time per task, time per bed and provider continuity. Further research should focus on the impact of these differences on outcomes and efficiency of medical ward care.
2015, Article / Letter to editor (Journal of Advanced Nursing, vol. 71, iss. 12, (2015), pp. 2998-3005)Aim. This protocol describes a systematic review that evaluates the effects of physician substitution by mid-level providers (nurse practitioners, physician assistants or nurses) in primary healthcare for older people and long-term care facilities. The secondary aim is to describe facilitators and barriers to the implementation of physician substitution in these settings. Background. Healthcare for older people is undergoing major changes, due to population ageing and reforms that shift care to the community. Besides, relatively few medical students are pursuing careers in healthcare for older people. Innovative solutions are needed to guarantee the quality of healthcare and to contain costs. A solution might be shifting care from physicians to mid-level providers. To date, no systematic review on this topic exits to guide policymaking. Design. A quantitative systematic literature review using Cochrane methods. Methods. The following databases will be searched for original research studies that quantitatively compare care provided by a physician to the same care provided by a mid-level provider: PubMed, EMBASE, CINAHL, PsycINFO, CENTRAL and Web of Science. Study selection, data extraction and quality appraisal will be conducted independently by two reviewers. Data synthesis will consist of a qualitative analysis of the data. Funding of the review was confirmed in August 2013 by the Ministry of Health, Welfare and Sport of the Netherlands. Discussion. This review will contribute to the knowledge on effects of physician substitution in healthcare for older people and factors that influence the outcomes. This knowledge will guide professionals and policy administrators in their decisions to optimize healthcare for older people.
2023, Article / Letter to editor (BMC Musculoskeletal Disorders, vol. 24, iss. 1, (2023), pp. 132)BACKGROUND: Chronic low back pain (CLBP) is the most common chronic pain condition worldwide. Currently, primary care physiotherapy is one of the main treatment options, but effects of this treatment are small. Virtual Reality (VR) could be an adjunct to physiotherapy care, due to its multimodal features. The primary aim of this study is to assess the (cost-)effectiveness of physiotherapy with integrated multimodal VR for patients with complex CLBP, compared to usual primary physiotherapy care. METHODS: A multicenter, two-arm, cluster randomized controlled trial (RCT) including 120 patients with CLBP from 20 physiotherapists will be conducted. Patients in the control group will receive 12nweeks of usual primary physiotherapy care for CLBP. Patients in the experimental group will receive treatment consisting of 12nweeks of physiotherapy with integrated, immersive, multimodal, therapeutic VR. The therapeutic VR consists of the following modules: pain education, activation, relaxation and distraction. The primary outcome measure is physical functioning. Secondary outcome measures include pain intensity, pain-related fears, pain self-efficacy and economic measures. Effectiveness of the experimental intervention compared to the control intervention on primary and secondary outcome measures will be analyzed on an intention-to-treat principle, using linear mixed-model analyses. DISCUSSION: This pragmatic, multicenter cluster randomized controlled trial, will determine the clinical and cost-effectiveness of physiotherapy with integrated, personalized, multimodal, immersive VR in favor of usual physiotherapy care for patients with CLBP. TRIAL REGISTRATION: This study is prospectively registered at ClinicalTrials.gov (identifier: NCT05701891).
2011, Book (monograph) Dit boek is een gids voor pijnbestrijding bij trauma patiënten. Verpleegkundigen in de ambulancezorg en op de spoedeisende hulp werken dagelijks met deze patiënten. De praktijkgids bundelt de wetenschappelijke kennis uit een richtlijn en promotieonderzoek op een toegankelijke manier. Helder geordend en compact geschreven behandelt deze gids alle aspecten van de zorg voor pijn bij trauma: wat is pijn, hoe kun je pijn meten en bestrijden en tot slot hoe kun je de pijnbestrijding in de spoedzorg goed organiseren? De informatie is geïllustreerd met casuïstiek en uitspraken van patiënten, verpleegkundigen en artsen. Ook is een stroomschema voor farmacologische pijnbehandeling toegevoegd. Aan het eind van de hoofdstukken zijn de aanbevelingen voor de praktijk in een kader samengevat.
2012, Part of book or chapter of book (, pp. 203-211)Venticare geeft onder de naam Capita selecta ieder jaar een interessante verzameling artikelen uit op het gebied van de intensive care-geneeskunde. Alle artikelen zijn geschreven door deskundigen uit het vakgebied. De nadruk ligt op de praktische toepasbaarheid van de beschreven stof.
2010, Article in monograph or in proceedings ()In this introductory paper we will successively describe:
1.The difficulties of innovation in the field of education.
2.The role of the education professionals.
3.Two different perspectives on innovation; an ‘external’ approach and an ‘internal’ approach.
4.Why education needs the internal approach and the professional as co-innovator.
5.The experiment: Pioneers of Innovation in primary education, an example of the internal approach.
6.Five concepts as guiding principles for the experiment.
7.A short description of the action research with the aim to improve this intervention and explore and sustain the effects of it.
2021, Part of book or chapter of book (Stel, J. van der (ed.), Wetenschap en praktijkgids voor (aankomende) professionals in zorg, welzijn en sociaal werk, pp. 139-145)
2022, Article in monograph or in proceedings (Plaats voor logistiek in autovrije gebiedsontwikkeling: van verschonen en verminderen naar ruimtelijk integreren)
2009, Article / Letter to editor (TVZ : verpleegkunde in praktijk en wetenschap, vol. 2009, (2009), pp. 38)Vlak na een operatie of bij sommige ziektes kunnen patiënten problemen hebben met de opname van voedsel doordat hun maag of slokdarm niet goed werkt. Het kan dan nodig zijn hen te voeden via een nasojejunum voedingssonde. De indicaties hiervoor zijn opgenomen in richtlijnen. De onderzoekers gingen na of de richtlijnen in de praktijk ook gevolgd werden.
2017, Part of book or chapter of book (Christensen, B.T.; Ball, L.J.; Halskov, K. (ed.), Analysing Design Thinking : studies of Cross-Cultural Co-Creation, pp. 21)
2010, Article / Letter to editor (Medicine and Science in Sports and Exercise, vol. 42, iss. 12, (2010), pp. 2264-2272)PURPOSE: The popularity of long-distance walking (LDW) has increased in the last decades. However, the effects of LDW on plantar pressure distribution and foot complaints, in particular, after several days of walking, have not been studied. METHODS: We obtained the plantar pressure data of 62 subjects who had no history of foot complaints and who walked a total distance of 199.8 km for men (n = 30) and 161.5 km for women (n = 32) during four consecutive days. Plantar pressure was measured each day after the finish (posttests I–IV) and compared with the baseline plantar pressure data, which was obtained 1 or 2 d before the march (pretest). Mean, peak, and pressure–time integral per pixel as well as the center of pressure (COP) trajectory of each foot per measurement day were calculated using the normalization method of Keijsers et al. A paired t-test with an adjusted P value was used to detect significant differences between pretest and posttest. RESULTS: Short-term adjustment to LDW resulted in a significant decreased loading on the toes accompanied with an increased loading on the metatarsal head III–V (P < 0.001). At all stages, particularly at later stages, there was significantly more heel loading (P < 0.001). Furthermore, the COP significantly displaced in the posterior direction but not in the mediolateral direction after marching. Contact time increased slightly from 638.5 +/- 24.2 to 675.4 +/- 22.5 ms (P < 0.001). CONCLUSIONS: The increased heel loading and decreased function of the toes found after marching indicate a change of walking pattern with less roll-off. It is argued that these changes reflect the effect of fatigue of the lower leg muscles and to avoid loading of the most vulnerable parts of the foot.