scholarly journals Insight into the process of postpartum care utilisation and in-home support among vulnerable women in the Netherlands: an in-depth qualitative exploration

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e046696
Author(s):  
Lyzette T Laureij ◽  
Marije van der Hulst ◽  
Jacqueline Lagendijk ◽  
Jasper V Been ◽  
Hiske E Ernst-Smelt ◽  
...  
Keyword(s):  
Social Network ◽  
The Netherlands ◽  
Postpartum Period ◽  
Self Efficacy ◽  
Postpartum Care ◽  
Theory Approach ◽  
Home Support ◽  
Care Utilisation ◽  
Qualitative Interview Study ◽  
Insight Into

ObjectiveTo gain insight into the process of postpartum care utilisation and in-home support among vulnerable women.Design, method, participants and settingA qualitative interview study was conducted among 23 pregnant and postpartum vulnerable women in the Netherlands, following a grounded theory approach. Women were determined as vulnerable by their healthcare providers. Theoretical sampling of participants was applied and was alternated by data analysis to include information-rich cases until saturation was achieved.ResultsA conceptual framework of postpartum care utilisation was generated consisting of three phases: pregnancy, early postpartum period and late postpartum period. Within these phases, information provision, parenting self-efficacy and social network were identified as overarching themes. Perceived inadequate information on content of postpartum care posed a major barrier to forming realistic expectations during pregnancy and hindered its utilisation. Low self-efficacy facilitated postpartum care utilisation. All women experienced increased self-efficacy during and after postpartum care. Support from a social network influenced expectations regarding the added value of postpartum care during pregnancy, and lowered actual utilisation during the postpartum period. The costs of postpartum care and the role of the maternity care assistant acted as general barriers or facilitators influencing the three overarching themes and therefore postpartum care utilisation indirectly.ConclusionsOur findings suggest that postpartum care utilisation among vulnerable women may be improved by considering the particular phase and relevant themes applying to individual women, and adapt care accordingly. We recommend to provide comprehensive, understandable information and to emphasise the gains of postpartum care in improving self-efficacy for vulnerable women. Moreover, involving a woman’s social network in postpartum care may add value to this care for this population.

scholarly journals What influences the outcome of active disinvestment processes in healthcare? A qualitative interview study on five recent cases of active disinvestment

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Adriënne H. Rotteveel ◽  
Mattijs S. Lambooij ◽  
Joline J. A. van de Rijt ◽  
Job van Exel ◽  
Karel G. M. Moons ◽  
...  
Keyword(s):  
The Netherlands ◽  
Healthcare Providers ◽  
Policy Decision ◽  
Structured Interviews ◽  
Qualitative Interview Study ◽  
Dutch Health ◽  
Financial Interests ◽  
Care Assistance ◽  
Insight Into

Abstract Background Recent attempts of active disinvestment (i.e. withdrawal of reimbursement by means of a policy decision) of reimbursed healthcare interventions in the Netherlands have differed in their outcome: some attempts were successful, with interventions actually being disinvested. Other attempts were terminated at some point, implying unsuccessful disinvestment. This study aimed to obtain insight into recent active disinvestment processes, and to explore what aspects affect their outcome. Methods Semi-structured interviews were conducted from January to December 2018 with stakeholders (e.g. patients, policymakers, physicians) who were involved in the policy process of five cases for which the full or partial withdrawal of reimbursement was considered in the Netherlands between 2007 and 2017: benzodiazepines, medication for Fabry disease, quit smoking programme, psychoanalytic therapy and maternity care assistance. These cases covered both interventions that were eventually disinvested and interventions for which reimbursement was maintained after consideration. Interviews were transcribed verbatim, double coded and analyzed using thematic analysis. Results The 37 interviews showed that support for disinvestment from stakeholders, especially from healthcare providers and policymakers, strongly affected the outcome of the disinvestment process. Furthermore, the institutional role of stakeholders as legitimized by the Dutch health insurance system, their financial interests in maintaining or discontinuing reimbursement, and the possibility to relieve the consequences of disinvestment for current patients affected the outcome of the disinvestment process as well. A poor organization of patient groups may make it difficult for patients to exert pressure, which may contribute to successful disinvestment. No evidence was found of a consistent role of the formal Dutch package criteria (i.e. effectiveness, cost-effectiveness, necessity and feasibility) in active disinvestment processes. Conclusions Contextual factors as well as the possibility to relieve the consequences of disinvestment for current patients are important determinants of the outcome of active disinvestment processes. These results provide insight into active disinvestment processes and their determinants, and provide guidance to policymakers for a potentially more successful approach for future active disinvestment processes.

scholarly journals What Influences the Outcome of Active Disinvestment Processes in Healthcare? A Qualitative Interview Study on five Recent Cases of Active Disinvestment

2020 ◽  
Author(s):  
Adriënne Henderika Rotteveel ◽  
Mattijs S. Lambooij ◽  
Joline J.A. van de Rijt ◽  
N.J.A. van Exel ◽  
Karel G.M. Moons ◽  
...  
Keyword(s):  
The Netherlands ◽  
Healthcare Providers ◽  
Policy Decision ◽  
Structured Interviews ◽  
Qualitative Interview Study ◽  
Dutch Health ◽  
Financial Interests ◽  
Care Assistance ◽  
Insight Into

Abstract Background: Recent attempts of active disinvestment (i.e. withdrawal of reimbursement by means of a policy decision) of reimbursed healthcare interventions in the Netherlands have differed in their outcome: some were successful, with interventions actually being disinvested, while others were terminated at some point, implying continuation of reimbursement. This study aimed to obtain insight into recent active disinvestment processes, and to explore what aspects affect their outcome.Methods: Semi-structured interviews were conducted from January to December 2018 with stakeholders (e.g. patients, policymakers, physicians) who were involved in the policy process of five cases for which the full or partial withdrawal of reimbursement was considered in the Netherlands between 2007 and 2017: benzodiazepines, medication for Fabry disease, quit smoking programme, psychoanalytic therapy and maternity care assistance. These cases covered both interventions that were eventually disinvested and interventions for which reimbursement was maintained after consideration. Interviews were transcribed verbatim, double coded and analyzed using thematic analysis.Results: The 37 interviews showed that support for disinvestment from stakeholders, especially from healthcare providers and policymakers, strongly affected the outcome of the disinvestment process. Furthermore, the institutional role of stakeholders as legitimized by the Dutch health insurance system, their financial interests in maintaining or discontinuing reimbursement, and the possibility to relieve the consequences of disinvestment for current patients affected the outcome of the disinvestment process as well. No evidence was found of a consistent role of the formal Dutch package criteria (i.e. effectiveness, cost-effectiveness, necessity and feasibility) in active disinvestment processes.Conclusions: Contextual factors as well as the possibility to relieve the consequences of disinvestment for current patients are important determinants of the outcome of active disinvestment processes. These results provide insight into active disinvestment processes and their determinants, and provide guidance to policymakers for a potentially more successful approach for future active disinvestment processes.

Mobile-Friendly Dashboards to Display Associations Between Cited-by and Similar Journals on Mobile Health Research: A Bibliometric Study (Preprint)

2018 ◽  
Author(s):  
Tsair-Wei Chien ◽  
Hsien-Yi Wang ◽  
Yang Shao ◽  
Willy Chou
Keyword(s):  
Social Network ◽  
Mobile Health ◽  
Health Research ◽  
Similarity Criteria ◽  
Network Density ◽  
Deep Insight ◽  
Density Indices ◽  
The Subject ◽  
The Given ◽  
Insight Into

BACKGROUND Researchers often spend a great deal of time and effort retrieving related journals for their studies and submissions. Authors often designate one article and then retrieve other articles that are related to the given one using PubMed’s service for finding cited-by or similar articles. However, to date, none present the association between cited-by and similar journals related to a given journal. Authors need one effective and efficient way to find related journals on the topic of mobile health research. OBJECTIVE This study aims (1) to show the related journals for a given journal by both cited-by and similarity criteria; (2) to present the association between cited-by and similarity journals related to a given journal; (3) to inspect the patterns of network density indices among clusters classified by social network analysis (SNA); (4) to investigate the feature of Kendall's coefficient(W) of concordance. METHODS We obtained 676 abstracts since 2013 from Medline based on the keywords of ("JMIR mHealth and uHealth"[Journal]) on June 30, 2018, and plotted the clusters of related journals on Google Maps by using MS Excel modules. The features of network density indices were examined. The Kendall coefficient (W) was used to assess the concordance of clusters across indices. RESULTS This study found that (1) the journals related to JMIR mHealth and uHealth are easily presented on dashboards; (2) a mild association(=0.14) exists between cited-by and similar journals related to JMIR mHealth and uHealth; (3) the median Impact Factor were 3.37 and 2.183 based on the representatives of top ten clusters grouped by the cited-by and similar journals, respectively; (4) all Kendall’s coefficients(i.e., 0.82, 0.89, 0.92, and 0.75) for the four sets of density centrality have a statistically significant concordance (p < 0.05). CONCLUSIONS SNA provides deep insight into the relationships of related journals to a given journal. The results of this research can provide readers with a knowledge and concept diagram to use with future submissions to a given journal in the subject category of Mobile Health Research. CLINICALTRIAL Not available

scholarly journals Strategies for the assessment of competences during rheumatology training across Europe: results of a qualitative study

RMD Open ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e001183 ◽  
Author(s):  
Aurélie Najm ◽  
Alessia Alunno ◽  
Francisca Sivera ◽  
Sofia Ramiro ◽  
Catherine Haines
Keyword(s):  
The Netherlands ◽  
Current Practice ◽  
Online Discussion ◽  
Qualitative Approach ◽  
Formative Feedback ◽  
Competence Assessment ◽  
The United Kingdom ◽  
Online Focus Groups ◽  
Assessment Systems ◽  
Insight Into

ObjectivesTo gain insight into current methods and practices for the assessment of competences during rheumatology training, and to explore the underlying priorities and rationales for competence assessment.MethodsWe used a qualitative approach through online focus groups (FGs) of rheumatology trainers and trainees, separately. The study included five countries—Denmark, the Netherlands, Slovenia, Spain and the United Kingdom. A summary of current practices of assessment of competences was developed, modified and validated by the FGs based on an independent response to a questionnaire. A prioritising method (9 Diamond technique) was then used to identify and justify key assessment priorities.ResultsOverall, 26 participants (12 trainers, 14 trainees) participated in nine online FGs (2 per country, Slovenia 1 joint), totalling 12 hours of online discussion. Strong nationally (the Netherlands, UK) or institutionally (Spain, Slovenia, Denmark) standardised approaches were described. Most groups identified providing frequent formative feedback to trainees for developmental purposes as the highest priority. Most discussions identified a need for improvement, particularly in developing streamlined approaches to portfolios that remain close to clinical practice, protecting time for quality observation and feedback, and adopting systematic approaches to incorporating teamwork and professionalism into assessment systems.ConclusionThis paper presents a clearer picture of the current practice on the assessment of competences in rheumatology in five European countries and the underlying rationale of trainers’ and trainees’ priorities. This work will inform EULAR Points-to-Consider for the assessment of competences in rheumatology training across Europe.

scholarly journals The switching mechanisms of social network densification

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Teruyoshi Kobayashi ◽  
Mathieu Génois
Keyword(s):  
Social Networks ◽  
Social Network ◽  
Social Context ◽  
Social Interactions ◽  
Regime Switching ◽  
Face To Face ◽  
The Social ◽  
Switching Property ◽  
Distinctive Type ◽  
Insight Into

AbstractDensification and sparsification of social networks are attributed to two fundamental mechanisms: a change in the population in the system, and/or a change in the chances that people in the system are connected. In theory, each of these mechanisms generates a distinctive type of densification scaling, but in reality both types are generally mixed. Here, we develop a Bayesian statistical method to identify the extent to which each of these mechanisms is at play at a given point in time, taking the mixed densification scaling as input. We apply the method to networks of face-to-face interactions of individuals and reveal that the main mechanism that causes densification and sparsification occasionally switches, the frequency of which depending on the social context. The proposed method uncovers an inherent regime-switching property of network dynamics, which will provide a new insight into the mechanics behind evolving social interactions.

Double, triple or quadruple hits? Exploring the impact of cybercrime on victims in the Netherlands

2021 ◽  
pp. 026975802110106
Author(s):  
Raoul Notté ◽  
E.R. Leukfeldt ◽  
Marijke Malsch
Keyword(s):  
Public Opinion ◽  
Literature Review ◽  
The Netherlands ◽  
Public Discourse ◽  
Moral Judgments ◽  
Victim Blaming ◽  
High Prevalence ◽  
Different Types ◽  
The Impact ◽  
Insight Into

This article explores the impact of online crime victimisation. A literature review and 41 interviews – 19 with victims and 22 with experts – were carried out to gain insight into this. The interviews show that most impacts of online offences correspond to the impacts of traditional offline offences. There are also differences with offline crime victimisation. Several forms of impact seem to be specific to victims of online crime: the substantial scale and visibility of victimhood, victimisation that does not stop in time, the interwovenness of online and offline, and victim blaming. Victims suffer from double, triple or even quadruple hits; it is the accumulation of different types of impact, enforced by the limitlessness in time and space, which makes online crime victimisation so extremely invasive. Furthermore, the characteristics of online crime victimisation greatly complicate the fight against and prevention of online crime. Finally, the high prevalence of cybercrime victimisation combined with the severe impact of these crimes seems contradictory with public opinion – and associated moral judgments – on victims. Further research into the dominant public discourse on victimisation and how this affects the functioning of the police and victim support would be valuable.

scholarly journals To sext or not to sext. The role of social-cognitive processes in the decision to engage in sexting

2021 ◽  
Vol 38 (4) ◽  
pp. 1410-1429
Author(s):  
Claire Wilson ◽  
Tommy van Steen ◽  
Christabel Akinyode ◽  
Zara P. Brodie ◽  
Graham G. Scott
Keyword(s):  
Cognitive Processes ◽  
Self Efficacy ◽  
Social Cognitive ◽  
Cognitive Factors ◽  
Relationship Status ◽  
Injunctive Norm ◽  
The Social ◽  
And Behavior ◽  
Insight Into

Technology has given rise to online behaviors such as sexting. It is important that we examine predictors of such behavior in order to understand who is more likely to sext and thus inform intervention aimed at sexting awareness. We used the Theory of Planned Behavior (TPB) to examine sexting beliefs and behavior. Participants (n = 418; 70.3% women) completed questionnaires assessing attitudes (instrumental and affective), subjective norms (injunctive and descriptive), control perceptions (self-efficacy and controllability) and intentions toward sexting. Specific sexting beliefs (fun/carefree beliefs, perceived risks and relational expectations) were also measured and sexting behavior reported. Relationship status, instrumental attitude, injunctive norm, descriptive norm and self-efficacy were associated with sexting intentions. Relationship status, intentions and self-efficacy related to sexting behavior. Results provide insight into the social-cognitive factors related to individuals’ sexting behavior and bring us closer to understanding what beliefs predict the behavior.

Overview of a Life Skills Coaching Program for Adults on the Autism Spectrum: Coaches’ Perspectives

2021 ◽  
pp. 003329412199102
Author(s):  
Ashleigh Hillier ◽  
Nataliya Poto ◽  
David Schena ◽  
Jessica Dorey ◽  
Abigail Buckingham ◽  
...  
Keyword(s):  
Service Provision ◽  
Self Efficacy ◽  
Life Skills ◽  
Autism Spectrum ◽  
Adults With Autism ◽  
Program Staff ◽  
Preliminary Examination ◽  
Effective Service ◽  
Insight Into

There is considerable need to identify effective service provision models to support adults on the autism spectrum as they seek to lead independent lives. This study outlines an individualized life skills coaching program for adults with autism, “LifeMAP”, and the experiences and perspectives of the coaches. Responses on a tailored questionnaire provided detailed insight into how the coaches were performing their job, the strategies they utilized, reasons for client success and difficulty, challenges faced by the coaches, and ways they were supported by program staff. Coaches’ job self-efficacy and satisfaction were also examined. This study serves as a preliminary examination of individualized coaching for adults with autism from the coaches’ perspective.

scholarly journals Staying neutral or intervening?

2021 ◽  
Author(s):  
Maartje Hoogsteyns ◽  
Amalia Muhaimin
Keyword(s):  
Medical Students ◽  
The Netherlands ◽  
Medical Ethics ◽  
Cultural Change ◽  
Moral Distress ◽  
Institutional Constraints ◽  
Neutral Position ◽  
Insight Into ◽  
Proper Response

AbstractEthics teachers are regularly confronted with disturbing cases brought in by medical students in class. These classes are considered confidential, so that everyone can speak freely about their experiences. But what should ethics teachers do when they hear about a situation they consider to be outright alarming, for example where patients/students’ safety is at stake or where systematic power abuse seems to be at hand? Should they remain neutral or should they step in and intervene? In the Netherlands, as in many other countries, there are no clear guidelines for ethics teachers on how to respond. To get more insight into what teachers themselves think a proper response would be, we interviewed 18 Dutch medical ethics teachers. We found that Dutch ethics teachers will address the issue in class, but that they are overall reluctant to intervene; take action outside the scope of class. This reluctance is partly rooted in the conviction that ethicists should stay neutral and facilitate reflection, instead of telling students or physicians what to do. At the same time, this neutral position seems a difficult place to leave for those teachers who would want to or feel they need to. This has to do with various organizational and institutional constraints tied up with their position. The study invites medical ethics teachers to reflect on these constraints together and think about how to proceed from there. This study seeks to contribute to research on cultural change in medicine and medical students’ experiences of moral distress.

scholarly journals Identification of Relevant Sociocognitive Determinants Explaining Multiple Parental Sun Protection Behaviors

2021 ◽  
pp. 109019812110104
Author(s):  
Karlijn Thoonen ◽  
Liesbeth van Osch ◽  
Rik Crutzen ◽  
Hein de Vries ◽  
Francine Schneider
Keyword(s):  
Skin Cancer ◽  
Self Efficacy ◽  
Sun Exposure ◽  
Later Life ◽  
Sun Protection ◽  
Survey Study ◽  
Skin Cancer Prevention ◽  
Sun Safety ◽  
And Behaviors ◽  
Insight Into

Background Adequate sun safety during childhood is crucial for decreasing skin cancer risk in later life. Although parents are an essential target group in applying sun protection measures for their children, insight into the determinants associated with their sun protection behaviors is limited. Aims This study aims to identify the most relevant determinants in predicting multiple parental sun protection intentions and behaviors in different sun exposure situations. Method A longitudinal survey study with two measurements was conducted among Dutch parents ( N = 670) of children (4–12 years old). Twenty-seven sociocognitive determinants were examined in terms of relevance regarding four parental sun protection behaviors in different sun exposure situations. The Confidence Interval-Based Estimation of Relevance approach was used to visualize room for improvement (sample means) on all determinants and their association strengths (correlations) with sun protection intentions and behaviors. Results Behavior-specific rather than generic determinants were most relevant in explaining all sun protection behaviors. Of these determinants, attitude, self-efficacy and action planning, and especially parental feelings of difficulty in performing sun protection behaviors, were most relevant. Altogether, the explained variance of all sociocognitive determinants was highest for shade-seeking behavior ( R2 = .41 and .43) and lowest for supportive behavior ( R2 = .19 and .29) in both planned and incidental sun exposure situations, respectively. Discussion This study provides detailed insight into relevant sociocognitive determinants of parental sun protection behaviors in various sun exposure situations and directions for composing parental skin cancer prevention interventions. Conclusions Future composition of sun safety interventions should emphasize on enhancing parental feelings of self-efficacy, especially for shade-seeking and clothing behaviors.

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