scholarly journals On intimate relationships between healthcare professionals and patients: a nationwide cohort analysis of medical tribunal decisions in the Netherlands

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Wim Rietdijk ◽  
Sander Renes
Keyword(s):  
The Netherlands ◽  
Intimate Relationships ◽  
Odds Ratio ◽  
Healthcare Professionals ◽  
Cohort Analysis ◽  
Intimate Relationship ◽  
Disciplinary Action ◽  
Future Research ◽  
Disciplinary Actions ◽  
Patient Interactions

Abstract Background We examine the incidence of medical tribunal decisions and disciplinary actions (DAs) against healthcare professionals (HCPs). In addition, we studied whether an intimate relationship between an HCP and patient as part of the medical tribunal decision is associated with an increased likelihood of disciplinary actions. Methods We conducted a nationwide cohort analysis on the downloadable medical tribunal decisions from a medical disciplinary tribunal in the Netherlands from 2010 to 2017. Results We found that 117 (2.8%) of the 4,046 medical tribunal decisions involved an alleged intimate relationship between an HCP and patient. In these medical tribunal decisions the likelihood of a disciplinary action was significantly increased (odds ratio [OR] 12.97, 95% Confidence Interval [95% CI] 7.11–23.64). In addition, we found that nurses and psychiatrists are more frequently accused of and receive disciplinary actions due to intimate relationships than other HCP groups. Conclusions We found a limited number of medical tribunal decisions involving an intimate relationship. Especially given the total number of medical tribunal decisions and the number of yearly HCP-patient interactions, the number appears small. Furthermore, an alleged intimate relationship or inappropriate sexual conduct is associated with an increased likelihood of disciplinary action. Future research should obtain statistics on the number of intimate relationships that actually start between HCPs and patients.

The Effect of Mental Illness on Segregation Following Institutional Misconduct

2018 ◽  
Vol 45 (9) ◽  
pp. 1363-1382 ◽  
Author(s):  
Kyleigh Clark
Keyword(s):  
Mental Illness ◽  
Mentally Ill ◽  
Odds Ratio ◽  
Future Research ◽  
Disciplinary Actions ◽  
Institutional Misconduct ◽  
The Impact ◽  
To Receive ◽  
Practical Implications

Recent anecdotal reports have suggested that disciplinary segregation in prison is disproportionately used against mentally ill inmates. To date, little research has examined this phenomenon empirically. This study analyzes the impact of a prediagnosed mental illness on the likelihood an inmate is sentenced to segregation following an institutional misconduct in state facilities. Findings suggest that inmates with a mental illness have a higher likelihood of being sentenced to segregation compared with inmates without a mental illness (odds ratio [OR] = 1.36), net of other factors. Further analyses indicate that mentally ill inmates are more likely to receive segregation compared with a range of other less serious disciplinary actions. Practical implications and directions for future research are explored.

scholarly journals Cycling in people with a lower limb amputation

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Jutamanee Poonsiri ◽  
Rienk Dekker ◽  
Pieter U. Dijkstra ◽  
Juha M. Hijmans ◽  
Jan H. B. Geertzen
Keyword(s):  
The Netherlands ◽  
Median Duration ◽  
Lower Limb ◽  
Odds Ratio ◽  
Lower Limb Amputation ◽  
Barriers And Facilitators ◽  
Limb Amputation ◽  
Future Research ◽  
Personal Motivation ◽  
Underlying Diseases

Abstract Background To evaluate cycling participation and identify barriers and facilitators related to cycling participation in people with a lower limb amputation (LLA) in the Netherlands. Methods A questionnaire was sent to adults with a LLA between March and August 2019 to obtain information regarding prosthesis, individual’s characteristics, amputation, cycling barriers and facilitators, and prosthetic satisfaction. The questionnaires were distributed via 8 orthopedic workshops, post and were given directly. To find cycling predictors, variables associated with cycling (p < 0.1) were entered into a logistic regression analysis. Non-significant variables were removed manually. Results Participants (n = 207, 71% males) had a mean age of 62.0 ± 13.0 years. The most frequent level of amputation was transtibial (42%), and trauma was the most frequent cause of amputation (43%). After the LLA, 141 participants (68%) cycled for recreation (80%), physical fitness (74%), and transport (50%). In the past six months, cyclists cycled for recreation (79%) and transport (66%). Most cycled less than once a day. Recreational cyclists cycled alone (75%) for a median duration of 45 min or 14 km per ride. Cyclists with a transportation purpose usually cycled to go shopping (80%) or to visit friends (68%), with a median duration of 20 min or five kilometers per ride. Cyclists reported more facilitators (median (IQR) = 5 (3, 7) than non-cyclists 0 (0, 3). The majority of cyclists reported a positive attitude toward cycling (89%) and cycled because of health benefits (81%). A dynamic foot (odds ratio: 5.2, 95% CI 2.0, 13.3) and a higher number of facilitators (odds ratio: 1.3, 95% CI 1.2, 1.5) positively predicted cycling, whereas the presence of other underlying diseases (odds ratio: 0.4, 95% CI 0.2, 0.9) negatively predicted cycling (R2: 40.2%). Conclusion In the Netherlands, the majority of adults cycled after a LLA, mainly for recreational purposes. A dynamic foot, a higher number of facilitators, and no other underlying diseases increases the likelihood of cycling after a LLA. The results suggest that personal motivation and a higher mobility level could be the key to increasing cycling participation. Future research should determine the association between motivation, mobility levels, and cycling with a LLA.

Ethnogeriatrics: Development and Application of the Cohort Analysis Tool

2014 ◽  
Vol 21 (2) ◽  
pp. 37-52
Author(s):  
Melen McBride
Keyword(s):  
Healthcare Professionals ◽  
Cohort Analysis ◽  
Analysis Tool ◽  
Speech Language Pathology ◽  
Clinical Tool ◽  
Research Activities ◽  
Key Concepts ◽  
Practice Teaching ◽  
Language Pathology ◽  
Significant Factors

Ethnogeriatrics is an evolving specialty in geriatric care that focuses on the health and aging issues in the context of culture for older adults from diverse ethnic backgrounds. This article is an introduction to ethnogeriatrics for healthcare professionals including speech-language pathologists (SLPs). This article focuses on significant factors that contributed to the development of ethnogeriatrics, definitions of some key concepts in ethnogeriatrics, introduces cohort analysis as a teaching and clinical tool, and presents applications for speech-language pathology with recommendations for use of cohort analysis in practice, teaching, and research activities.

scholarly journals Complementary Medicine and Self-Care Strategies in Women with (Recurrent) Urinary Tract and Vaginal Infections: A Cross-Sectional Study on Use and Perceived Effectiveness in The Netherlands

Antibiotics ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 250
Author(s):  
Louise Witteman ◽  
Herman A. van Wietmarschen ◽  
Esther T. van der Werf
Keyword(s):  
Urinary Tract ◽  
The Netherlands ◽  
Complementary Medicine ◽  
Self Care ◽  
Future Research ◽  
Perceived Effectiveness ◽  
Vaginal Infections ◽  
Cross Sectional ◽  
Treatment Implementation ◽  
Specific Symptoms

Due to the excessive use of antibiotic and antimycotic treatments, the risk of resistant microbes and fungi is rapidly emerging. Previous studies have demonstrated that many women with (recurrent) urinary tract infection (UTI) and/or vaginal infections (VIs) welcome alternative management approaches to reduce the use of antibiotics and antifungals and avoid short- and long-term adverse effects. This study aims to determine which complementary medicine (CM) and self-care strategies are being used by women suffering from (recurrent) UTI and VI in The Netherlands and how they perceive their effectiveness in order to define directions for future research on safety, cost-effectiveness, and implementation of best practices. A cross-sectional online survey was performed among women, ≥18 years old, with a history of UTIs; 162 respondents were included in the data analysis, with most participants aged between 50 and 64 years (36.4%). The women reported having consulted a CM practitioner for UTI-specific symptoms (23.5%) and VI-specific symptoms (13.6%). Consultations of homeopaths, acupuncturists, and herbal physicians are most often reported. Overall, 81.7% of the women suffering from UTI used complementary or self-care strategies besides regular treatment, and 68.7% reported using CM/self-care strategies to treat vaginal symptoms. UTI- related use of cranberries (51.9%), vitamin C (43.8%), and D-mannose (32.7%) were most reported. Perceived effectiveness was mostly reported for homeopathic remedies and D-mannose. The results showed a substantial burden of UTI and VI on daily and sexual activities. Besides the frequency of use, the indication of perceived effectiveness seems to be an important parameter for further and rigorously designed research to encourage nonantibiotic/antifungal treatment implementation into daily clinical practice.

scholarly journals The impact of regionalized trauma care on the distribution of severely injured patients in the Netherlands

2021 ◽  
Author(s):  
Suzan Dijkink ◽  
Erik W. van Zwet ◽  
Pieta Krijnen ◽  
Luke P. H. Leenen ◽  
Frank W. Bloemers ◽  
...  
Keyword(s):  
The Netherlands ◽  
Trauma Care ◽  
Trauma System ◽  
Future Research ◽  
Severely Injured ◽  
Trauma Centers ◽  
Severely Injured Patients ◽  
The Right ◽  
Injured Patients ◽  
The Impact

Abstract Background Twenty years ago, an inclusive trauma system was implemented in the Netherlands. The goal of this study was to evaluate the impact of structured trauma care on the concentration of severely injured patients over time. Methods All severely injured patients (Injury Severity Score [ISS] ≥ 16) documented in the Dutch Trauma Registry (DTR) in the calendar period 2008–2018 were included for analysis. We compared severely injured patients, with and without severe neurotrauma, directly brought to trauma centers (TC) and non-trauma centers (NTC). The proportion of patients being directly transported to a trauma center was determined, as was the total Abbreviated Injury Score (AIS), and ISS. Results The documented number of severely injured patients increased from 2350 in 2008 to 4694 in 2018. During this period, on average, 70% of these patients were directly admitted to a TC (range 63–74%). Patients without severe neurotrauma had a lower chance of being brought to a TC compared to those with severe neurotrauma. Patients directly presented to a TC were more severely injured, reflected by a higher total AIS and ISS, than those directly transported to a NTC. Conclusion Since the introduction of a well-organized trauma system in the Netherlands, trauma care has become progressively centralized, with more severely injured patients being directly presented to a TC. However, still 30% of these patients is initially brought to a NTC. Future research should focus on improving pre-hospital triage to facilitate swift transfer of the right patient to the right hospital.

scholarly journals Sexual healthcare professionals’ views on the rapid provision of remote services at the beginning of COVID-19 pandemic: A mixed-methods study

2021 ◽  
pp. 095646242110230
Author(s):  
Alexandria Lunt ◽  
Carrie Llewellyn ◽  
Jake Bayley ◽  
Tom Nadarzynski
Keyword(s):  
Health Services ◽  
Sexual Health ◽  
Health Inequalities ◽  
Online Survey ◽  
Healthcare Professionals ◽  
Digital Tools ◽  
Future Research ◽  
Snowball Sampling ◽  
Remote Services ◽  
Sexual Healthcare

Introduction: The COVID-19 pandemic and social distancing measures forced sexual health services to engage with patients remotely. We aimed to understand perceived barriers and facilitators to the provision of digital sexual health services during the first months of the pandemic. Methods: An online survey and qualitative interviews with UK sexual healthcare professionals recruited online and via snowball sampling were conducted in May–July 2020. Results: Amongst 177 respondents (72% female, 86% White, mean age = 46, SD = 9), most utilised telephone and email as their main communication channels; however, their perceived effectiveness varied (94% and 66%, respectively). Most agreed that staff needed additional training (89%), the available technology was not adequate (66%) and health professionals were hesitant to provide online consultations (46%). They had positive attitudes towards digitalisation, improving service quality and cost-effectiveness but were concerned about exacerbating health inequalities. Discussion: The study identifies a need for clear guidelines and training around the use of digital tools as well as a demand for investment in hardware and software required for the provision of remote services. Future research needs to explore the acceptability, safety and effectiveness of various digital tools to narrow health inequalities in sexual health service users.

In the Moment: Fostering Mindfulness and Reducing Stressors in the Healthcare Workplace

2021 ◽  
pp. 193758672098824
Author(s):  
Shabboo Valipoor ◽  
Sheila J. Bosch
Keyword(s):  
Design Research ◽  
Healthcare Professionals ◽  
Well Being ◽  
Job Dissatisfaction ◽  
Future Research ◽  
Design Strategies ◽  
Environmental Interventions ◽  
Work Related ◽  
Healthcare Settings ◽  
The Moment

While healthcare design research has primarily focused on patient outcomes, there is a growing recognition that environmental interventions could do more by promoting the overall quality of care, and this requires expanding the focus to the health and well-being of those who deliver care to patients. Healthcare professionals are under high levels of stress, leading to burnout, job dissatisfaction, and poor patient care. Among other tools, mindfulness is recommended as a way of decreasing stress and helping workers function at higher levels. This article aims to identify potential environmental strategies for reducing work-related stressors and facilitating mindfulness in healthcare settings. By examining existing evidence on workplace mindfulness and stress-reducing design strategies, we highlight the power of the physical environment in not only alleviating stressful conditions but intentionally encouraging a mindful perspective. Strategies like minimizing distractions or avoiding overstimulation in the healthcare environment can be more effective if implemented along with the provision of designated spaces for mindfulness-based programs. Future research may explore optimal methods and hospital workers’ preferences for environments that support mindfulness and stress management. The long-term goal of all these efforts is to enhance healthcare professionals’ well-being, reignite their professional enthusiasm, and help them be resilient in times of stress.

Care at home for people with dementia: as in a total institution?

2006 ◽  
Vol 27 (1) ◽  
pp. 3-24 ◽  
Author(s):  
JANET ASKHAM ◽  
KATE BRIGGS ◽  
IAN NORMAN ◽  
SALLY REDFERN
Keyword(s):  
Intimate Relationships ◽  
Social Relationship ◽  
Intimate Relationship ◽  
Total Institution ◽  
Home Life ◽  
The People ◽  
People With Dementia ◽  
Custodial Care ◽  
Care At Home ◽  
At Home

This article examines three kinds of social relationship likely to be present when people with dementia are cared for at home by relatives or friends: custodial care, an intimate relationship, and home-life. Using Goffman's three defining aspects of custodial care – routinisation, surveillance and mortification of the self – the paper examines whether these characterised the care of people with dementia at home and, if so, whether they conflicted with the intimate relationship and with home-life. The study involved sustained observations and interviews with 20 people with dementia and their carers in and around London, and qualitative analysis of the data. It was found that all three aspects of custodial care were present although not fully realised, and that they led to difficulties, many of which were associated with the concurrent pursuit of an intimate relationship and home-life. In all cases, daily life was routinised partly to help accomplish care tasks but was found monotonous, while surveillance was usual but restrictive, and prevented both the carers and those with dementia from doing things that they wished to do. Those with dementia were distressed by the denial of their former identities, such as car-driver or home-maker, and by being treated like children. Both the carers and the people with dementia had various ways of balancing custodial care, their intimate relationships and home-life, such as combining routines with other activities, evading surveillance or carrying it out by indirect means, and there were many attempts to maintain some semblance of former identities.

Heeft de evaluatie van reïntegratiebeleid nog toekomst?

2005 ◽  
Vol 21 (1) ◽  
Author(s):  
Pierre Koning
Keyword(s):  
The Netherlands ◽  
Labour Market ◽  
Evaluation Studies ◽  
Future Research ◽  
Welfare To Work ◽  
Labour Market Policies ◽  
Active Labour Market Policies ◽  
Active Labour ◽  
Proper Account

Does the evaluation of active labour market policies have any future? Does the evaluation of active labour market policies have any future? The literature on the effectiveness of welfare-to-work services (i.e. schooling and job counseling) in the Netherlands provides a gloomy picture. First, only a few studies take proper account of selectivity and endogeneity biases. Second, the results of this (subset of) studies suggest that both schooling and counseling have only a modest, or no significant impact. In this article, I discuss various explanations for these findings. Furthermore, I describe various avenues for future research in this area, as well as the organization of more sound evaluation studies.

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