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  • 1.
    Anrys, Charlotte
    et al.
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
    Van Tiggelen, Hanne
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
    Verhaeghe, Sofie
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department Health Care, VIVES University College, Roeselare, Belgium.
    Van Hecke, Ann
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; School of Nursing & Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
    Independent risk factors for pressure ulcer development in a high-risk nursing home population receiving evidence-based pressure ulcer prevention: Results from a study in 26 nursing homes in Belgium2019In: International Wound Journal, ISSN 1742-4801, E-ISSN 1742-481X, Vol. 16, no 2, p. 325-333Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to identify independent risk factors for pressure ulcer (PU) development in a high-risk nursing home population receiving evidence-based PU prevention. This study was part of a randomised controlled trial examining the (cost-)effectiveness of static air support surfaces compared with alternating pressure air mattresses. The sample consisted of 308 residents at a high risk of PU development (presence of non-blanchable erythema, Braden score ≤ 12 or Braden subscale "mobility" ≤ 2). PU incidence was monitored for 14 days. Demographic variables; functional, physical, and psychological characteristics; and data on skin assessment were collected. Independent risk factors were identified using multiple logistic regression analysis. The overall PU incidence (category II-IV) was 8.4% (n = 26), and 1.9% (n = 6) of the residents developed a deep PU (category III-IV). PUs (category II-IV) were significantly associated with non-blanchable erythema, a lower Braden score, and pressure area-related pain in high-risk residents even if preventive care was provided. These results highlight the need of a systematic risk assessment, including pain assessment and skin observations, in order to determine and tailor preventive care to the needs of high-risk individuals.

  • 2.
    Antierens, Alain
    et al.
    CNO, BZIO Rehabilitation Hospital, Ostend, Belgium; Faculty of Medicine and Health Sciences, Department of Public Health, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium.
    Beeckman, Dimitri
    Faculty of Medicine and Health Sciences, Department of Public Health, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium; School of Health Sciences, University of Surrey, Guilford, UK; School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland.
    Verhaeghe, Sofie
    Faculty of Medicine and Health Sciences, Department of Public Health, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium; Department Health Care, VIVES University College, Roeselare, Belgium.
    Myny, Dries
    CNO, BZIO Rehabilitation Hospital, Ostend, Belgium; CNO, OLV van Lourdes Hospital, Waregem, Belgium.
    Van Hecke, Ann
    Faculty of Medicine and Health Sciences, Department of Public Health, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
    How much of Toyota's philosophy is embedded in health care at the organisational level? A review2018In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 26, no 4, p. 348-357Article, review/survey (Refereed)
    Abstract [en]

    AIMS: Identify which of Toyota's principles are reported in health care institutions at the organisational level and to identify the type of reported outcomes related to the effectiveness of lean production reported in these studies.

    BACKGROUND: No scientific research has been conducted to determine which of Toyota's principles are embedded in health care systems. This knowledge is needed to perform targeted adjustments in health care.

    EVALUATION: Sixty studies were identified for the final analysis.

    KEY ISSUE(S): Some Toyota Way principles appear more deeply embedded in health care institutions than others are.

    CONCLUSION: Not all principles of Toyota's philosophy and production system were embedded in the studies in this review. The type of reported outcomes at the organisational level was diverse.

    IMPLICATIONS FOR NURSING MANAGEMENT: This literature review increases our knowledge about how many (and which) of the Toyota Way principles are embedded in health care. This knowledge may support reflection by nursing managers about how the full range of lean management principles could be embedded at the managerial and/or operational level.

  • 3.
    Antierens, Alain
    et al.
    CNO, BZIO Rehabilitation Hospital, Ostend, Belgium; Faculty of Medicine and Health Sciences, Department of public Health, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Belgium; School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Ireland.
    Verhaeghe, Sofie
    Faculty of Medicine and Health Sciences, Department of public Health, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium; Department of Nursing, VIVES University College, Roeselare, Belgium.
    Van Hecke, Ann
    Faculty of Medicine and Health Sciences, Department of public Health, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium; Staff member Nursing Department, Ghent University Hospital, Belgium.
    Wanted in health care: Lean experts with a broad perspective2019In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 27, no 6, p. 1332-1336Article in journal (Refereed)
    Abstract [en]

    AIM: To reflect on Lean experts' perspective on components of Lean management in health care and its implications for practice.

    BACKGROUND: The involvement of Lean experts is one of the key success factors of a sustainable Lean transformation in health care.

    EVALUATION: Thirteen Lean experts participated in two focus groups. They all had experience in the implementation of Lean in healthcare organizations.

    KEY ISSUES: Lean experts all seem to have a unique perspective on Lean management in health care. Experts without a healthcare degree appear to focus more on the entire management system, where experts with a nursing degree seem to concentrate more on the soft Lean principles.

    CONCLUSION: The description of Lean and its components in health care differed between Lean experts. Their professional background appears to have an influence.

    IMPLICATIONS FOR NURSING MANAGEMENT: In selecting a Lean expert, nurse managers may want to gauge what elements the Lean expert tends to emphasize. It seems plausible to opt for a Lean expert without a healthcare degree to accomplish the Lean transformation as they have a broader view on Lean. It may also be useful for managers to involve several Lean experts, all with complementary perspectives and backgrounds.

  • 4.
    Beeckman, Dimitri
    et al.
    Örebro University, School of Health Sciences. Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Belgium; School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Ireland; Research Unit of Plastic Surgery, Department of Clinical Research, Faculty of Health Sciences, Southern Denmark; School of Nursing and Midwifery, Monash University, Australia .
    Serraes, Brecht
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Belgium; Nursing department (General Hospital) AZ Nikolaas, Sint-Niklaas, Belgium.
    Anrys, Charlotte
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Belgium.
    Van Tiggelen, Hanne
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Belgium.
    Van Hecke, Ann
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Belgium.
    Verhaeghe, Sofie
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Belgium.
    A multicentre prospective randomised controlled clinical trial comparing the effectiveness and cost of a static air mattress and alternating air pressure mattress to prevent pressure ulcers in nursing home residents2019In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 97, p. 105-113Article in journal (Refereed)
    Abstract [en]

    Background: Pressure ulcers are a global issue and substantial concern for healthcare systems. Various types of support surfaces that prevent pressure ulcer are available. Data about the effectiveness and cost of static air support surfaces and alternating air pressure mattresses is lacking.

    Objectives: To compare the effectiveness and cost of static air support surfaces versus alternating air pressure support surfaces in a nursing home population at high risk for pressure ulcers.

    Design: Prospective, multicentre, randomised controlled clinical, non-inferiority trial.

    Setting: Twenty-six nursing homes in Flanders, Belgium.

    Participants: A consecutive sample of 308 participants was selected based on the following eligibility criteria: high risk for pressure ulcer and/or with category 1 pressure ulcer, being bedbound and/or chair bound, aged > 65 years, and use of an alternating air pressure mattress.

    Methods: The participants were allocated to the intervention group (n = 154) using static air support surfaces and the control group (n = 154) using alternating air pressure support surfaces. The main outcome measures were cumulative incidence and incidence density of the participants developing a new category II-IV pressure ulcer within a 14-day observation period, time to develop a new pressure ulcer, and purchase costs of the support surfaces.

    Results: The intention-to-treat analysis revealed a significantly lower incidence of category II-IV pressure ulcer in the intervention group (n = 8/154, 5.2%) than in the control group (n = 18/154, 11.7%) (p = 0.04). The median time to develop a pressure ulcer was significantly longer in the intervention group (10.5 days, interquartile range [IQR]: 1-14) than in the control group (5.4 days, [IQR]: 1-12; p = 0.05). The probability to remain pressure ulcer free differed significantly between the two study groups (log-rank X-2 = 4.051, df =1, p = 0.04). The overall cost of the mattress was lower in the intervention group than in the control group.

    Conclusions: A static air mattress was significantly more effective than an alternating air pressure mattress in preventing pressure ulcer in a high-risk nursing home population. Considering multiple lifespans and purchase costs, static air mattresses were more cost-effective than alternating air pressure mattresses.

  • 5.
    Beele, Hilde
    et al.
    Department of Dermatology, Ghent University Hospital, Ghent, Belgium; Wound Care Centre, Ghent University Hospital, Ghent, Belgium.
    Smet, Steven
    Wound Care Centre, Ghent University Hospital, Ghent, Belgium.
    Van Damme, Nele
    Skin Integrity Research Group (SKINT), Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.
    Beeckman, Dimitri
    Skin Integrity Research Group (SKINT), Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.
    Incontinence-Associated Dermatitis: Pathogenesis, Contributing Factors, Prevention and Management Options2018In: Drugs & Aging, ISSN 1170-229X, E-ISSN 1179-1969, Vol. 35, no 1, p. 1-10Article in journal (Refereed)
    Abstract [en]

    Incontinence-associated dermatitis (IAD) is a common type of irritant contact dermatitis, seen in patients with urinary or faecal incontinence. Mechanical factors such as traumata and friction may aggravate the lesions. The fragile skin in elderly patients is more prone to developing IAD. The clinical picture of IAD consists of persistent redness on the one hand and skin loss on the other. Both categories may be associated with clinical signs of major colonisation or infection. It is important to distinguish IAD from pressure ulcers and other dermatoses in the genital region. Due to the lack of well-established clinical trials, recommendations about prevention and treatment are based on expert opinion and best practice. Gentle cleansing, use of hydrating topical agents and application of barrier products are the main elements in the prevention and treatment of IAD. It is important to translate these recommendations and general guidelines into ready-to-use protocols that can be implemented for each specific clinical manifestation of IAD.

  • 6.
    Browning, Paul
    et al.
    UK.
    Beeckman, Dimitri
    Department of Public Health and Primary Care, Ghent University, Belgium.
    White, Richard
    University of Worcester, Worcester, UK.
    Connolly, Roisin
    King's College Hospital NHS Foundation Trust, London, UK.
    Rodgers, Angela
    NHS Royal Hospital for Children, Glasgow, Ireland.
    Maclean, Gillian
    Royal Infirmary of Edinburgh, Edinburgh, UK.
    Fumarola, Sian
    University Hospitals of North Midlands NHS Trust, UK.
    Harker, Judy
    Acute Hospitals NHS Trust, UK.
    Murray, Victoria
    UK.
    Foster, Steve
    UK.
    Report of the proceedings of a UK skin safety advisory group2018In: British Journal of Nursing, ISSN 0966-0461, E-ISSN 2052-2819, Vol. 27, no 20, p. S34-S40Article in journal (Refereed)
    Abstract [en]

    Moisture-associated skin damage, especially incontinence-associated dermatitis, continues to present significant health challenges and requires multidisciplinary input to provide effective prevention and treatment. In the absence of mandatory reporting such damage is under- or wrongfully reported, resulting in a lack of accurate data on prevalence and costs of associated care. In March this year, a multidisciplinary team of experts met in the UK to seek to determine measures to improve patient skin care. They aimed to identify activities to increase awareness and education, collect data, and improve prevention and treatment regimes. This article describes that discussion and the conclusions made by the group, such as the key actions required to effect policy changes.

  • 7.
    De Meyer, D.
    et al.
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
    Van Hecke, A.
    University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
    Verhaeghe, S.
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department Health Care, VIVES University College, Roeselare, Belgium.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
    PROTECT - Trial: A cluster RCT to study the effectiveness of a repositioning aid and tailored repositioning to increase repositioning compliance2019In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 75, no 5, p. 1085-1098Article in journal (Refereed)
    Abstract [en]

    AIM: To study the effectiveness of tailored repositioning and a turning and repositioning system on: (1) nurses' compliance to repositioning frequencies; (2) body posture of patients after repositioning; (3) incidence of pressure ulcers and incontinence-associated dermatitis; (4) nurses' and patients' preferences, comfort and acceptability; and (5) budget impact.

    BACKGROUND: Patient-tailored systematic repositioning is key in pressure ulcer prevention. To date, a clinical decision-making tool is lacking and compliance to pressure ulcer prevention guidelines is low. Research concerning commercially available turning and repositioning systems is lacking.

    DESIGN: Multicentre, cluster, three-arm, randomised, controlled pragmatic trial.

    METHODS: Two hundred twenty-seven patients at risk of pressure ulcer development were recruited at 29 wards in 16 hospitals between February 2016 - December 2017. Wards were randomly assigned to two experimental groups and one control group.

    RESULTS: Nurses' compliance to repositioning frequencies increased significantly in the experimental groups when patients were cared for in bed (94.6% versus 69% and 84.9% versus 71.4%). Applying the turning and repositioning system was associated with significantly more correctly positioned patients (30-45° tilted side-lying position) (69.6% versus 34.6%). Few pressure ulcers and incontinence-associated dermatitis incidents occurred. Both patients and nurses were positive about the intervention. Higher labour costs related to repositioning in bed were found in the control group.

    CONCLUSION: This was the first study investigating the effect of tailored repositioning and the use of a repositioning aid to increase nurses' compliance to repositioning. The results were in favour of the interventions yet demonstrating the importance of follow-up and education.

  • 8.
    De Meyer, Dorien
    et al.
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
    Gabriel, Sabrina
    Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Germany.
    Kottner, Jan
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Germany.
    Van Damme, Nele
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
    Van Den Bussche, Karen
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
    Verhaeghe, Sofie
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department Health Care, VIVES University College, Roeselare, Belgium.
    Van Hecke, Ann
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
    Outcome measurement instruments for erythema associated with incontinence-associated dermatitis: systematic review2019In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Article, review/survey (Refereed)
    Abstract [en]

    AIM: To: (1) examine which outcome measurement instruments for erythema associated with incontinence-associated dermatitis with supporting evidence about measurement properties are available; (2) evaluate the methodological quality of the studies and the quality of the measurement properties; and (3) identify eligible instruments to measure erythema in incontinence-associated dermatitis research.

    DESIGN: Systematic review.

    DATA SOURCES: MEDLINE, EMBASE, CINAHL and CENTRAL were systematically searched until July 2018 (update December 2018). Additional input was gathered from 151 incontinence-associated dermatitis experts. Cited and citing references of included studies were screened.

    REVIEW METHODS: The COSMIN Risk of Bias checklist was applied to evaluate the methodological quality of the studies. Reported measurement properties were rated against criteria for good measurement properties.

    RESULTS: Fourteen studies, describing 10 measurement instruments, were included. In five instruments, erythema was captured as a separate concept, two studies provided empirical evidence about the measurement properties. The most studied measurement properties were reliability (9 studies), measurement error (4 studies) and criterion validity (4 studies). In one study, internal consistency was examined.

    CONCLUSION: No instrument measuring exclusively erythema associated with incontinence-associated dermatitis exists. There is no single composite incontinence-associated dermatitis measurement instrument that outperforms others. Development or adaption of an instrument to measure erythema associated with incontinence-associated dermatitis is one option to solve this challenge.

    IMPACT: The evidence about measurement properties of instruments measuring erythema associated with incontinence-associated dermatitis has not been summarized to date. The lack of an instrument should trigger activities to measure this domain accurately in future clinical trials.

  • 9.
    De Meyer, Dorien
    et al.
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
    Kottner, Jan
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Charité-Universitätsmedizin, Berlin, Germany.
    Beele, Hilde
    Department of Dermatology, Ghent University Hospital, Ghent, Belgium.
    Schmitt, Jochen
    Center for Evidence-Based Healthcare, Medizinische Fakultät Carl Gustav Carus TU Dresden, Dresden, Germany.
    Lange, Toni
    Center for Evidence-Based Healthcare, Medizinische Fakultät Carl Gustav Carus TU Dresden, Dresden, Germany.
    Van Hecke, Ann
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
    Verhaeghe, Sofie
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department Health Care, VIVES University College, Roeselare, Belgium.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
    Delphi Procedure In Core Outcome Set Development: Rating Scale And Consensus Criteria Determined Outcome Selection2019In: Journal of Clinical Epidemiology, ISSN 0895-4356, E-ISSN 1878-5921, Vol. 111, p. 23-31Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To compare two different rating scales within one Delphi study for defining consensus in core outcome set development and to explore the influence of consensus criteria on the outcome selection.

    STUDY DESIGN: Randomized controlled parallel group trial with 1:1 allocation within the first Delphi round of the Core Outcome Set in the Incontinence-Associated Dermatitis (CONSIDER) project. Outcomes were rated on a three-point or nine-point Likert scale. Decisions about which outcomes to retain were determined by commonly used consensus criteria (i.e., (combinations of) proportions with restricted ranges, central tendency within a specific range and decrease in variance).

    RESULTS: Fifty-seven participants (group 1=28, group 2=29) rated 58 outcomes. The use of the nine-point scale resulted in almost twice as many outcomes being rated as 'critical' compared to the three-point scale (24 versus 13). Stricter criteria and combining criteria led to less outcomes being identified as 'critical'.

    CONCLUSION: The format of rating scales in Delphi studies for core outcome set development and the definition of the consensus criteria influence outcome selection. The use of the nine-point scale might be recommended to inform the consensus process for a subsequent rating or face-to-face meeting. The three-point scale might be preferred when determining final consensus.

  • 10.
    De Meyer, Dorien
    et al.
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
    Verhaeghe, Sofie
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department Health Care, VIVES University College, Roeselare, Belgium.
    Van Hecke, Ann
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
    Knowledge of nurses and nursing assistants about pressure ulcer prevention: A survey in 16 Belgian hospitals using the PUKAT 2.0 tool2019In: Journal of tissue viability, ISSN 0965-206X, Vol. 28, no 2, p. 59-69Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Pressure ulcers have a high impact on patients and their families. Profound and up-to-date knowledge among nurses is important given the effect on attitudes and preventative behaviour. To gain insight into educational needs and priorities, regular knowledge assessments are needed.

    OBJECTIVE: To gain insight into the knowledge of nurses and nursing assistants about pressure ulcer prevention.

    DESIGN: Cross-sectional multicentre study.

    METHODS: 474 nurses and nursing assistants recruited at 29 wards in 16 hospitals completed individually the PUKAT 2.0, a valid and reliable questionnaire to measure nurses knowledge about pressure ulcer prevention. Data were collected between February 2016 and December 2017. Independent sample t-tests, one-way analyses of variance and Kruskal-wallis tests were performed to analyse the results.

    RESULTS: The mean total score was 50.7%. The lowest scores were found in the themes knowledge about prevention (42.7%), aetiology (45.6%) and prevention for specific patient groups (46.6%). Higher educational level (H = 40.43, p < 0.001) and attending additional training about pressure ulcers or wound care in general (t = 2.93, p = 0.004) resulted in significant higher total knowledge scores.

    CONCLUSION: The results of this study highlight an important knowledge deficit about pressure ulcer prevention. The PUKAT 2.0 knowledge assessment tool made it possible to differentiate between a variety of cognitive process levels. This allowed to identify knowledge gaps and focus areas for continuing professional education. Education curricula for nurses and associated healthcare professionals are to be screened thoroughly and the identified knowledge gaps should be covered. Besides, multifaceted strategies are needed to improve clinical practice.

  • 11.
    De Roose, Marjon
    et al.
    University Centre for Nursing&Midwifery, Department of Public Health, Ghent University, Ghent, Belgium.
    Tency, Inge
    University Centre for Nursing&Midwifery, Department of Public Health, Ghent University, Ghent; Odisee University College, Department Midwifery, Belgium.
    Beeckman, Dimitri
    University Centre for Nursing&Midwifery, Department of Public Health, Ghent University, Ghent.
    Van Hecke, Ann
    University Centre for Nursing&Midwifery, Department of Public Health, Ghent University, Ghent; Nursing Science, Ghent University Hospital, Ghent, Belgium.
    Verhaeghe, Sofie
    University Centre for Nursing&Midwifery, Department of Public Health, Ghent University, Ghent, Belgium.
    Clays, Els
    Department of Public Health, Ghent University, Ghent, Belgium.
    Knowledge, attitude, and practices regarding miscarriage: A cross-sectional study among Flemish midwives2018In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 56, p. 44-52Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: to examine the knowledge, attitude and practices (KAP) of Flemish midwives regarding miscarriage.

    DESIGN AND SETTING: a cross-sectional KAP study was conducted in 28 hospitals in Flanders (Northern region of Belgium) from September 2015 to January 2016.

    PARTICIPANTS: a total of 647 out of 1200 midwives (53.9%) working on maternity, labour and gynaecological wards, maternal and neonatal (intensive) care units, antenatal consultations, and reproductive medicine were recruited.

    MEASUREMENTS: data were collected using a semi-structured, self-administered questionnaire.

    FINDINGS: = 96.574, df = 1, p<0.001). The majority (72.4%) indicated a lack of knowledge regarding miscarriage. Almost 89% expressed a need for extra training.

    CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: midwives in Flanders assist in the care for couples with miscarriage and consider themselves as a key healthcare provider in the psychosocial support. This study highlighted several barriers regarding miscarriage care, e.g. a lack of knowledge and incapability. Adequate training in knowledge and communication skills is important and necessary in order to promote appropriate care to couples experiencing pregnancy loss and increase awareness among all health professionals involved in obstetric care. Further research should investigate to what extent miscarriage is included in the educational midwifery programmes, and how the current healthcare practice regarding miscarriage care is organised.

  • 12.
    Debyser, Bart
    et al.
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; VIVES University of Applied Sciences, Kortrijk, Belgium; Psychiatric Hospital, Centre for Psychiatry & Psychotherapy Clinic St-Joseph, Pittem, Belgium.
    Berben, Kevin
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Alexian Psychiatric Hospital, Tienen, Alexianen Care Group, Tienen, Belgium.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Department of Public Health and Primary Care, Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland.
    Deproost, Eddy
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; VIVES University of Applied Sciences, Kortrijk, Belgium; Psychiatric Hospital, Centre for Psychiatry & Psychotherapy Clinic St-Joseph, Pittem, Belgium.
    Van Hecke, Ann
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Department of Public Health and Primary Care, Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Staff member Nursing Department, Ghent University Hospital, Ghent, Belgium.
    Verhaeghe, Sofie
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; VIVES University of Applied Sciences, Kortrijk, Belgium.
    The transition from patient to mental health peer worker: A grounded theory approach2019In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 28, no 2, p. 560-571Article in journal (Refereed)
    Abstract [en]

    Peer workers are increasingly being engaged in contemporary mental healthcare. To become a peer worker, patients must evolve from having a patient identity to a peer worker identity. This study aims to understand how mental health peer workers experience their transition and how it affects their view of themselves and their direct working context. A grounded theory approach was used. Seventeen mental health peer workers in Belgium were recruited through theoretical sampling. Semi-structured interviews were conducted and analysed according to the constant comparative method. The results indicate that novice peer workers experience peer work as an opportunity to liberate themselves from the process of mental suffering and realise an acceptable form of personal self-maintenance. As peer workers become more experienced, they are confronted with external factors that influence their self-maintenance and personal development. Experiencing clarity in their duties and responsibilities, equality, and transparency in the workplace reinforce their experience of self-maintenance and positively influence their self-development. Experiencing a lack of clarity in their duties and responsibilities, inequality, and lack of openness discourage peer workers' self-development process. These experiences challenge their personal motivations to become peer workers, which are usually linked to building a meaningful life for themselves. The insights can encourage organisations to build up a supportive environment collaboratively with peer workers and ensure that peer workers can exert their authentically unique role in mental healthcare.

  • 13.
    Debyser, Bart
    et al.
    Department of Public Health, Ghent University, Ghent, Belgium; Department of Nursing, VIVES University College, Roeselare, Belgium; Centre for Psychiatry and Psychotherapy Clinic St Joseph, Psychiatric Hospital, Pittem, Belgium.
    Duprez, Veerle
    Department of Public Health, Ghent University, Ghent, Belgium.
    Beeckman, Dimitri
    Department of Public Health, Ghent University, Ghent, Belgium.
    Vandewalle, Joeri
    Department of Public Health, Ghent University, Ghent, Belgium.
    Van Hecke, Ann
    Department of Public Health, Ghent University, Ghent, Belgium; Department of Public Health, Ghent University, Ghent, Belgium; Department of Nursing, Ghent University Hospital, Ghent, Belgium.
    Deproost, Eddy
    Department of Public Health, Ghent University, Ghent, Belgium; Department of Nursing, VIVES University College, Roeselare, Belgium; Centre for Psychiatry and Psychotherapy Clinic St Joseph, Psychiatric Hospital, Pittem, Belgium.
    Verhaeghe, Sofie
    Department of Public Health, Ghent University, Ghent, Belgium; Department of Nursing, VIVES University College, Roeselare, Belgium.
    Mental health nurses and mental health peer workers: Self-perceptions of role-related clinical competences2018In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, no 3, p. 987-1001Article in journal (Refereed)
    Abstract [en]

    In a mental healthcare that embraces a recovery-oriented practice, the employment of mental health peer workers is encouraged. Although peer workers are increasingly working together with nurses, there is a lack of research that explores how nurses and peer workers perceive their role-related competences in clinical practice. The aim of this study was to clarify and understand these self-perceptions in order to identify the specificity and potential complementarity of both roles. This insight is needed to underpin a successful partnership between both vocations. A qualitative descriptive research design based on principles of critical incident methodology was used. Twelve nurses and eight peer workers from different mental healthcare organizations participated. A total of 132 reported cases were analysed. Rigour was achieved through thick description, audit trail, investigator triangulation and peer review. Nurses relate their role-related competences predominantly with being compliant with instructions, being a team player and ensuring security and control. Peer workers relate their role-related competences with being able to maintain themselves as a peer worker, building up a relationship that is supportive for both the patient and themselves, and to utilize their lived experience. Both nurses and peer workers assign a major role to the team in determining their satisfaction with their competences. Consequently, what is perceived as important for the team appears to overshadow their self-assessment of competences. The findings highlighted the importance of paying more attention to identity construction, empowerment and role competence development of nurses and peer workers in their respective education and ongoing training.

  • 14.
    Duprez, Veerle
    et al.
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
    Vansteenkiste, Maarten
    Developmental Psychology, Department of developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; School of Nursing & Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
    Verhaeghe, Sofie
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium;VIVES University College, Department Health Care, Roeselare, Belgium.
    Van Hecke, Ann
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Ghent University Hospital, Ghent, Belgium.
    Capturing motivating versus demotivating self-management support: Development and validation of a vignette-based tool grounded in Self-determination Theory2019In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, article id S0020-7489(19)30125-7Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The trend towards more active involvement of patients in the management of their chronic condition requires professionals to interact in a way that facilitates patients' autonomy and motivation. A self-assessment tool that measures simultaneously motivating and demotivating interaction styles in counselling chronic ill patients is currently not available.

    OBJECTIVES: Grounded in Self-Determination Theory, this study aimed to develop and validate a self-report tool that captures healthcare professionals' motivating (i.e., autonomy-support and structure) and demotivating (i.e., control and chaos) interaction styles while supporting patients towards self-management.

    METHODS: The Situations In Self-management support - HealthCare Professionals (SIS-HCP) was developed throughout a five-phased psychometric validation study with (1) construct definition, (2) development of the vignette-based questionnaire, (3) ecological validation and piloting, (4) psychometric evaluation (round 1) by multidimensional scaling analysis, and (5) psychometric evaluation (round 2) by internal and construct validity, and reliability testing procedures in 5 independent samples (total N = 1133), between August 2015 and March 2018.

    RESULTS: Multidimensional scaling analysis provided evidence for a two-dimensional structure, with motivating, relative to demotivating counselling and high, relative to low, directive counselling representing the two axes. Four styles could be distinguished: autonomy-support (rather motivating and non-directive), structure (rather motivating & directive), control (rather demotivating & directive) and chaos (rather demotivating & non-directive) within self-management support. The SIS-HCP demonstrated good construct validity, and high internal consistency and test-retest reliability.

    CONCLUSION: The SIS-HCP is a vignette-based tool, which allows to explore, in an integrative way, which motivating (i.e., autonomy-support and structure) and demotivating (i.e., control and chaos) styles healthcare professionals use when counselling patients living with a chronic illness. The SIS-HCP might enhance professionals' awareness of their (de)motivating counselling styles and the extent to which they promote ownership among patients. The SIS-HCP represents an interesting addition to existing instruments which measure what professionals do in the field of self-management support, and how confident they feel doing so. The thorough process of development and validation led to a theoretical underpinned tool, with the identified (de)motivating dimensions yielding strong psychometric properties. The SIS-HCP can be used as a reflective tool for professionals and for tailored training.

  • 15.
    Duprez, Veerle
    et al.
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
    Vansteenkiste, Maarten
    Department of developmental, personality and social psychology, Ghent University, Ghent, Belgium.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; School of Nursing & Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
    Verhaeghe, Sofie
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; VIVES University College - Department Health Care, Roeselare, Belgium.
    Van Hecke, Ann
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Ghent University Hospital, Ghent, Belgium.
    Is nurses' self-esteem interwoven with patients' achievements? The concept of patient-invested contingent self-esteem2019In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 28, no 21-22, p. 3858-3865Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To explore the notion of Patient-invested Contingent Self-Esteem (Pa-CSE) and investigate its association to nurses' self-reported engagement in controlling or autonomy-supportive interactions with chronic care patients.

    BACKGROUND: Considering the high number of patients sub-optimally managing their chronic condition, nurses might experience a drop and rise in self-worth when patients fail and succeed, respectively, in managing their chronic condition. This dynamic has not received prior research attention.

    DESIGN: Multivariate analysis employing cross-sectional data according to STROBE guidelines.

    METHODS: Self-reports among nurses employed in chronic care (N=394) from eight randomly selected hospitals in Belgium. Exploratory factor analysis and stepwise linear regression analyses were conducted.

    RESULTS: Success-based and failure-based orientations could be distinguished and refer to nurses' tendency to associate, respectively, patients' successes with feelings of professional success and self-worth and patients' failures with feelings of professional failure, shame, and inadequacy. Nurses' self-esteem is fairly interwoven with patients' achievements in the management of their chronic condition. A success-based orientation was positively related to autonomy-supportive care in case a failure-based orientation was low. Nurses with a simultaneous success-based and failure-based orientation interacted in a more controlling way.

    CONCLUSIONS: The findings of this study suggest that basing one's self-worth on patients' accomplishments may be a double-edged sword. Although tying one's personal glory to the successes of one's patient is related to greater patient participation and support of autonomy, these effects only emerge if nurses' self-worth is not interwoven with patients' failures. In fact, having both success- and failure-oriented contingent self-worth is related to a more pressuring approach.

    RELEVANCE TO CLINICAL PRACTICE: To prevent nurses from developing inferior professional feelings when their patients fail to manage their condition, a reflective stance towards the impact of patients' behaviour on the nurses' professional feeling of (in)adequacy is an important step to deal with such situations.

  • 16.
    Ghijselings, Lynn
    et al.
    Urology Department, Ghent University Hospital, Ghent University, Ghent, Belgium.
    Van De Putte, Dirk
    Colorectal Surgery, Ghent University Hospital, Ghent University, Ghent, Belgium.
    Hervé, François
    Urology Department, Ghent University Hospital, Ghent University, Ghent, Belgium; Urology Department, UCL University Hospital, Woluwe, Belgium.
    Goessaert, An-Sofie
    Urology Department, Ghent University Hospital, Ghent University, Ghent, Belgium.
    Beeckman, Dimitri
    Department of Public Health and Primary Care, Ghent University Hospital, Ghent University, Ghent, Belgium.
    Pattyn, Piet
    Urology Department, UCL University Hospital, Woluwe, Belgium.
    Everaert, Karel
    Urology Department, Ghent University Hospital, Ghent University, Ghent, Belgium.
    The OptiLUTS trial: improving care for therapy-resistant symptoms of the pelvis in Belgium2019In: Acta clinica Belgica, ISSN 1784-3286, p. 1-6Article in journal (Refereed)
    Abstract [en]

    Introduction/Background: The management of therapy-resistant lower urinary tract symptoms (LUTS) and symptoms resulting from pelvic organ dysfunctions are subject to a high variability in the Belgian health-care centres. Practical guidelines and standardized patient clinical care pathways are often lacking and unadapted to the Belgian healthcare system.

    Objectives: The OptiLUTS trial aims to improve the multidisciplinary care of therapy-resistant symptoms of the pelvis in the Belgian healthcare setting.

    Project A aims for the improvement of knowledge of 2nd line treatments for LUTS among general practitioners. In project B a treatment algorithm for the overactive bladder syndrome and non-obstructive urinary retention will be developed specifically for Belgium. In Project C a patient customized sacral neuromodulation (SNM) care pathway will be set up.

    Methods: Part A: Explorative study among general practitioners by distribution of a questionnaire.

    Part B: Review of existing guidelines and use of the Delphi method to obtain expert consensus. Part C: A single center comparative study to compare outcomes before and after implementation of the SNM care pathway. Patients scheduled for the first stage of Interstim therapy™ will be included (N=100). Primary endpoints are the sensitivity and specificity of a new pelvic symptom assessment tool, the conversion to implant and explantation rates.

    Conclusion: There is a margin for improvement in the care process of patients with therapy-resistant symptoms of the pelvis in the Belgium healthcare system. In the OptiLUTs trial adapted guidelines and a clinical care pathway will be developed to standardize and increase the efficiency of care.

    Trial registration: Approval for the trial by the Ethics Committee of the Ghent University hospital: EC/2018/0244.

  • 17.
    Goemaes, Régine
    et al.
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.
    Lernout, Emma
    Department of Public Health and Primary Care, Alumni Master of Science in Nursing and Midwifery, Ghent University, Ghent, Belgium.
    Goossens, Sophie
    Department of Public Health and Primary Care, Alumni Master of Science in Nursing and Midwifery, Ghent University, Ghent, Belgium.
    Decoene, Elsie
    Cancer Centre, Ghent University Hospital, Ghent, Belgium.
    Verhaeghe, Sofie
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; VIVES University College, Roeselare, Belgium.
    Beeckman, Dimitri
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.
    Van Hecke, Ann
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
    Time use of advanced practice nurses in hospitals: A cross-sectional study2019In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 75, no 12, p. 3588-3601Article in journal (Refereed)
    Abstract [en]

    AIMS: To examine the use of time by advanced practice nurses and time use differences according to type of healthcare organization, work experience, and supervisor.

    DESIGN: A cross-sectional, observational study.

    METHODS: Non-participant observations were executed in Belgium (October 2015-January 2016). Time use was categorized in domains (patient/family, team, healthcare organization) and roles (clinical expert, educator/coach, change agent/innovator, researcher, leader, collaborator, and ethical decision-making facilitator). Proportional working time in domains and roles was calculated. Chi-squared tests identified differences in time use according to type of healthcare organization, number of years of work experience, and type of hierarchical/functional supervisor.

    RESULTS: Participants mainly devoted time to the patient/family domain (30.78%) and the clinical expert role (34.19%). The role of leader and ethical decision-making facilitator covered, respectively, 4.84% and 0.07% of participants' time. Time distribution in domains and roles differed between participants in university and peripheral hospitals.

    CONCLUSION: Activities were executed in all domains and roles, except for the ethical decision-making facilitator role. Further research could uncover barriers and facilitators for role execution, especially about leadership and ethical decision-making.

    IMPACT: Advanced practice nurses, supervisors and policymakers could act to optimize advanced practice nurses' scope of practice.

  • 18.
    Goemaes, Régine
    et al.
    University Centre for Nursing and Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
    Shawe, Jill
    School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Duke of Kent Building, Guildford, Surrey, UK.
    Beeckman, Dimitri
    University Centre for Nursing and Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
    Decoene, Elsie
    Cancer Centre, Ghent University Hospital, Ghent University Hospital, Ghent, Belgium.
    Verhaeghe, Sofie
    University Centre for Nursing and Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
    Van Hecke, Ann
    University Centre for Nursing and Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Nursing Science, Ghent University Hospital, Ghent, Belgium.
    Factors influencing the implementation of advanced midwife practitioners in healthcare settings: A qualitative study2018In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 66, p. 88-96Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To explore factors influencing the implementation of advanced midwife practitioner roles.

    DESIGN: Semi-structured individual face-to-face and focus group interviews were conducted. Data analysis was performed using the Framework Method.

    SETTING AND PARTICIPANTS: A purposive sample (n = 32) included chief nursing officers, middle managers, head midwives/nurses, primary care team leaders, midwives with and without advanced midwife practitioner roles, heads of midwifery educations, and obstetricians.

    FINDINGS: Budgetary constraints on a governmental and healthcare organizational level were mentioned as main barriers for role implementation. The current fee-for-service financing model of healthcare professionals was also seen as an impediment. Obstetricians considered the implementation of advanced midwife practitioner roles as a possible financial and professional threat. Documenting the added value of advanced midwife practitioner roles was regarded a prerequisite for gaining support to implement such roles. Healthcare managers' and midwives' attitudes towards these roles were considered essential. Participants warned against automatically transferring the concept of advanced practice nursing to midwifery. Although participants seldom discussed population healthcare needs as a driver for implementation, healthcare organizations' heightened focus on quality improvement and client safety was seen as an opportunity for implementation. University hospitals were perceived as pioneers regarding advanced midwife practitioner roles.

    KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Multiple factors influencing role implementation on a governmental, healthcare organizational, and workforce level illustrate the complexity of the implementation process, and highlight the need for a well-thought-out implementation plan involving all relevant stakeholders. Pilot projects for the implementation of advanced midwife practitioners in university hospitals might be useful.

  • 19.
    Goossens, Joline
    et al.
    University Centre for Nursing&Midwifery, Department of Public Health, Ghent University, Ghent, Belgium.
    Beeckman, Dimitri
    University Centre for Nursing&Midwifery, Department of Public Health, Ghent University, Ghent, Belgium.
    Van Hecke, Ann
    University Centre for Nursing&Midwifery, Department of Public Health, Ghent University, Ghent, Belgium; Nursing Science, University Hospital Ghent, Ghent, Belgium.
    Delbaere, Ilse
    VIVES University College, Kortrijk, Belgium.
    Verhaeghe, Sofie
    University Centre for Nursing&Midwifery, Department of Public Health, Ghent University, Ghent, Belgium.
    Preconception lifestyle changes in women with planned pregnancies2018In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 56, p. 112-120Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: (1) to study preconception lifestyle changes and associated factors in women with planned pregnancies; (2) to assess the prevalence of risk factors for adverse pregnancy outcomes in women not reporting any preconception lifestyle changes; and (3) to explore the need for and use of preconception-related advice.

    DESIGN: secondary data analysis of a cross-sectional study about pregnancy planning.

    SETTING: six Flemish Hospitals (Belgium).

    PARTICIPANTS: four hundred and thirty women with a planned pregnancy ending in birth.

    MEASUREMENTS: preconception lifestyle changes were measured during the first 5 days postpartum using the validated London Measure of Unplanned Pregnancy. The following changes were assessed: folic acid or multivitamin intake, smoking reduction or cessation, alcohol reduction or cessation, caffeine reduction or cessation, eating more healthily, achieving a healthier weight, obtaining medical or health advice, or another self-reported preconception lifestyle change.

    FINDINGS: most women (83%) that planned their pregnancy reported ≥1 lifestyle change in preparation for pregnancy. Overall, nulliparous women (OR 2.18, 95% CI 1.23-3.87) and women with a previous miscarriage (OR 2.44, 95% CI 1.14-5.21) were more likely to prepare for pregnancy, while experiencing financial difficulties (OR 0.20, 95% CI 0.04-0.97) or having a lower educational level (OR 0.56, 95% CI 0.32-0.99) decreased the likelihood of preparing for pregnancy. Half of the women (48%) obtained advice about preconception health, and 86% of these women received their advice from a professional caregiver. Three-quarters (77%) of the women who did not improve their lifestyle before conceiving reported one or more risk factors for adverse pregnancy outcomes.

    KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: multiparous women and women of lower socio-economic status were less likely to change their lifestyle before conception. Strategies to promote preconception health in these women need to be tailored to their needs and characteristics to overcome barriers to change. It may be advantageous to reach these women through non-medical channels, such as schools or other community organizations.

  • 20.
    Goossens, Joline
    et al.
    University Centre for Nursing & Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
    De Roose, Marjon
    University Centre for Nursing & Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
    Van Hecke, Ann
    University Centre for Nursing & Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Nursing Science, University Hospital Ghent, Ghent, Belgium.
    Goemaes, Régine
    University Centre for Nursing & Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
    Verhaeghe, Sofie
    University Centre for Nursing & Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; VIVES University College, Department Health Care, Belgium.
    Beeckman, Dimitri
    University Centre for Nursing & Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University,Ghent, Belgium; School of Health Sciences, Faculty of Health & Medical Sciences, University of Surrey,Guildford Surrey, United Kingdom.
    Barriers and facilitators to the provision of preconception care by healthcare providers: A systematic review2018In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 87, p. 113-130Article, review/survey (Refereed)
    Abstract [en]

    BACKGROUND: Healthcare providers play an important role in providing preconception care to women and men of childbearing age. Yet, the provision of preconception care by healthcare providers remains low.

    OBJECTIVES: To provide an overview of barriers and facilitators at multiple levels that influence the provision of preconception care by healthcare providers.

    DESIGN: A mixed-methods systematic review.

    DATA SOURCES: PubMed, Web of Science, CINAHL, The Cochrane Library, and EMBASE were systematically searched up to April 27, 2017. The search strategy contained MeSH terms and key words related to preconception care and healthcare providers. Reference lists of included studies and systematic reviews on preconception care were screened.

    REVIEW METHODS: Publications were eligible if they reported on barriers and facilitators influencing the provision of preconception care by healthcare providers. Data were extracted by two independent reviewers using a data extraction form. Barriers and facilitators were organized based on the social ecological model. The methodological quality of included studies was evaluated using the Critical Appraisal Skills Programme Qualitative checklist for qualitative studies, the Quality Assessment Tool for quantitative studies, and the Mixed Methods Appraisal Tool for mixed methods studies.

    RESULTS: Thirty-one articles were included. Barriers were more reported than facilitators. These were situated at provider level (unfavourable attitude and lack of knowledge of preconception care, not working in the field of obstetrics and gynaecology, lack of clarity on the responsibility for providing preconception care) and client level (not contacting a healthcare provider in the preconception stage, negative attitude, and lack of knowledge of preconception care). Limited resources (lack of time, tools, guidelines, and reimbursement) were frequently reported at the organizational and societal level.

    CONCLUSIONS: Healthcare providers reported more barriers than facilitators to provide preconception care, which might explain why the provision of preconception care is low. To overcome the different client, provider, organizational, and societal barriers, it is necessary to develop and implement multilevel interventions.

  • 21.
    Goossens, Joline
    et al.
    University Centre for Nursing & Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
    Van Hecke, Ann
    University Centre for Nursing & Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Nursing Science, University Hospital Ghent, Ghent, Belgium.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Belgium; Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Belgium; School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Ireland.
    Verhaeghe, Sofie
    University Centre for Nursing & Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; VIVES University College, Department Health Care, Roeselare, Belgium.
    The intention to make preconception lifestyle changes in men: Associated socio-demographic and psychosocial factors2018In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 73, p. 8-16Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To determine which socio-demographic and psychosocial factors are associated with the intention for preconception healthily behavioral changes in the general population of reproductive-aged men.

    DESIGN: A cross-sectional, multicenter study.

    SETTING: Four secondary schools, 4 Public Centers for Social Welfare, 7 Community Health Centers, and online. All data was collected in the X.

    PARTICIPANTS: A convenience sample of 304 reproductive-aged men were recruited between July 2015 and July 2016.

    MEASUREMENTS AND FINDINGS: An existing questionnaire was adapted and validated to assess the intention, self-efficacy, attitude, social influence, knowledge, and barriers towards 10 preconception health behaviors. Simple and multiple logistic and linear regression analyses were performed. The overall intention to make preconception lifestyle changes was high (median score: 0.7 on the 0-1 scale). The multiple linear regression revealed that self-efficacy (p < 0.001), social influence of the close social environment (p = 0.02), and attitude (p = 0.05) were associated with a higher intention score. Experiencing negative emotions and beliefs about pre-pregnancy preparations was associated with less intention for preconception health behaviors (p = 0.001). None of the socio-demographic factors was significantly associated with the intention score.

    KEY CONCLUSIONS: The overall intention to make preconception lifestyle changes was high, and associated with different psychosocial factors including self-efficacy, social influence, and attitude.

    IMPLICATIONS FOR PRACTICE: Preconception interventions should target the identified factors to improve preconception health behaviors in men and negative emotions and beliefs about preconception. Interventions about preconception health care should primarily suggest that men bear the same responsibility as women, which will address the current gender politics and could have -in second instance- a positive outcome on pregnancy outcomes. Because socio-demographic characteristics were of no influence, a general approach should be used.

  • 22.
    Goossens, Joline
    et al.
    University Centre for Nursing & Midwifery, Department of Public Health, Ghent University, Ghent, Belgium.
    Verhaeghe, Sofie
    University Centre for Nursing & Midwifery, Department of Public Health, Ghent University, Ghent, Belgium.
    Van Hecke, Ann
    University Centre for Nursing & Midwifery, Department of Public Health, Ghent University, Ghent, Belgium; Nursing Science, University Hospital Ghent, Ghent, Belgium.
    Barrett, Geraldine
    Research Department of Reproductive Health, Institute for Women's Health, University College London, London, United Kingdom.
    Delbaere, Ilse
    VIVES University College, Kortrijk, Belgium.
    Beeckman, Dimitri
    University Centre for Nursing & Midwifery, Department of Public Health, Ghent University, Ghent, Belgium.
    Psychometric properties of the Dutch version of the London Measure of Unplanned Pregnancy in women with pregnancies ending in birth2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 4, article id e0194033Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate the psychometric properties of the Dutch version of the London Measure of Unplanned Pregnancy in women with pregnancies ending in birth.

    METHODS: A two-phase psychometric evaluation design was set-up. Phase I comprised the translation from English into Dutch and pretesting with 6 women using cognitive interviews. In phase II, the reliability and validity of the Dutch version of the LMUP was assessed in 517 women giving birth recently. Reliability (internal consistency) was assessed using Cronbach's alpha, inter-item correlations, and corrected item-total correlations. Construct validity was assessed using principal components analysis and hypothesis testing. Exploratory Mokken scale analysis was carried out.

    RESULTS: 517 women aged 15-45 completed the Dutch version of the LMUP. Reliability testing showed acceptable internal consistency (alpha = 0.74, positive inter-item correlations between all items, all corrected item-total correlations >0.20). Validity testing confirmed the unidimensional structure of the scale and all hypotheses were confirmed. The overall Loevinger's H coefficient was 0.57, representing a 'strong' scale.

    CONCLUSION: The Dutch version of the LMUP is a reliable and valid measure that can be used in the Dutch-speaking population in Belgium to assess pregnancy planning. Future research is necessary to assess the stability of the Dutch version of the LMUP, and to evaluate its psychometric properties in women with abortions.

  • 23.
    Johansen, Edda
    et al.
    University of South-Eastern Norway, Drammen, Norway.
    Bakken, Linda N.
    University of South-Eastern Norway, Drammen.
    Duvaland, Elisabeth
    Drammen Hospital, Vestre Viken HF, Drammen, Norway.
    Faulstich, Jürgen
    Drammen Hospital, Vestre Viken HF, Drammen, Norway.
    Hoelstad, Hanne L.
    Drammen Hospital, Vestre Viken HF, Drammen, Norway.
    Moore, Zena
    Royal College of Surgeons in Ireland, Dublin, Ireland.
    Vestby, Eva Marie
    Ringerike Hospital, Vestre Viken HF, Hønefoss, Norway.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. University Centre for Nursing and Midwifery, Ghent University, Belgium; School of Health Sciences, Nursing and Midwifery, University of Surrey, Guildford, UK; School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland.
    Incontinence-Associated Dermatitis (IAD): Prevalence and Associated Factors in 4 Hospitals in Southeast Norway2018In: Journal of Wound, Ostomy and Continence Nursing (WOCN), ISSN 1071-5754, E-ISSN 1528-3976, Vol. 45, no 6, p. 527-531Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim of this study was to investigate the prevalence and severity of incontinence-associated dermatitis (IAD) and associated factors in acute care settings in Southeast Norway.

    DESIGN: Descriptive, multisite epidemiologic survey.

    SUBJECTS AND SETTING: The study setting was 29 wards across 4 hospitals, in a hospital trust in the southeast of Norway. Data were collected from 340 patients (age ≥18 years). More than half (56.2%) were 70 years or older (median age category 70-79 years) and 53.3% were male.

    METHODS: Data collection was conducted in parallel with a pressure injury prevalence study undertaken in 2016. A modified Pressure Injury Prevalence Minimum Data Set, including documentation of fecal or urinary incontinence, use of indwelling fecal collection system or urinary catheter, and presence of IAD, was completed. RNs participating in the study were trained by the researchers on skin assessment and data extraction from the electronic medical record. Descriptive statistics were used for prevalence figures; the Kruskal-Wallis and χ tests were used to determine associated factors.

    RESULTS: Analysis revealed that 16.5% (56 out of 340) of the sample were incontinent. The prevalence of IAD in the total population was 7.6% (26 out of 340). The prevalence of IAD was 29% (16 out of 56) among patients with urinary or fecal incontinence. Of those identified with IAD, 5.2% (18 out of 340) had category 1 (red intact skin) and 2.4% (8 of 340) had category 2 (red skin with breakdown). Bivariate analysis revealed that fecal incontinence (P < .001), immobility (P < .01), and 70 years or older (P < .03) were associated with IAD.

    CONCLUSIONS: The overall prevalence (patients with and without incontinence) of IAD was lower than reported in prior studies; frequent use of indwelling urinary catheters and a relatively low prevalence of incontinence may explain this finding. Similar to prior studies, almost 1 in 3 patients who were incontinent suffered from IAD, showing a need for evidence-based guidelines to prevent IAD in hospitalized patients. Findings suggest that particular attention should be given to prevent IAD among patients with fecal incontinence patients, 70 years and older, and those with immobility.

  • 24.
    Knibbe, Nico E.
    et al.
    LOCOmotion Research, Bennekom, the Netherlands.
    Zwaenepoel, Elien
    Skin Integrity and Clinical Nursing, Ghent University, Ghent, Belgium.
    Knibbe, Hanneke Jj.
    LOCOmotion Research, Bennekom, the Netherlands.
    Beeckman, Dimitri
    Ghent, , Ghent University, Belgium.
    An automatic repositioning system to prevent pressure ulcers: a case series2018In: British Journal of Nursing, ISSN 0966-0461, E-ISSN 2052-2819, Vol. 27, no 6, p. S16-S22Article in journal (Refereed)
    Abstract [en]

    The Danish automated Vendlet V5s repositioning system is intended to reduce pressure ulcer risk in patients and work-related musculoskeletal disorders (MSDs) in caregivers. In two Belgian nursing homes, 13 residents with mobility levels C, D and E experienced the repositioning system, operated by 35 caregivers, for 4 weeks. Data about skin condition, nursing time needed for repositioning and MSD symptoms were collected. The use of the repositioning system was not associated with the development of nor a reduction in skin problems; the study included residents who were vulnerable to or already had pressure ulcers. In addition, four pressure ulcers healed during the experiment. The research focused only on the automated repositioning system. Repositioning frequency and postures were determined by the standard nursing home protocol. Frequency depended on the support surface in use, and a limited number of patient criteria (mobility in bed, presence of bony prominences/pressure points and presence of non-blanchable erythema). In future studies, the Vendlet V5s system should be tested with a more individualised patient repositioning protocol, including more criteria such as fever and moisture. The automated system reduces nursing time so could potentially improve staff efficiency. Compared with manual repositioning, caregivers perceived fewer work-related MSD symptoms during repositioning when using the Vendlet V5s system. Controlled studies with larger samples are needed to verify these conclusions.

  • 25.
    LeBlanc, Kimberly
    et al.
    NSWOCC Institute, Western University, London, Ontario, Canada.
    Campbell, Karen E.
    Western University and Lawson Research Institute, London, Ontario, Canada.
    Wood, Eleanor
    Wounds UK and Wounds International, London, United Kingdom.
    Beeckman, Dimitri
    University Centre of Nursing and Midwifery at Ghent University, Ghent, Belgium.
    Best Practice Recommendations for Prevention and Management of Skin Tears in Aged Skin: An Overview2019In: Journal of Wound, Ostomy and Continence Nursing (WOCN), ISSN 1071-5754, E-ISSN 1528-3976, Vol. 45, no 6, p. 540-542Article in journal (Refereed)
  • 26.
    Lechner, Anna
    et al.
    Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin Science, Charité – Universitätsmedizin Berlin, Berlin, Germany.
    Kottner, Jan
    Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin Science, Charité – Universitätsmedizin Berlin, Berlin, Germany; University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.
    Coleman, Susanne
    Institute of Clinical Trials Research, Clinical Trials Research Unit, University of Leeds, Leeds, UK.
    Muir, Delia
    Institute of Clinical Trials Research, Clinical Trials Research Unit, University of Leeds, Leeds, UK.
    Bagley, Heather
    Clinical Trials Research Centre (CTRC), North West Hub for Trials Methodology, University of Liverpool, Liverpool, UK.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; School of Health Sciences, Nursing and Midwifery, University of Surrey, Guildford, UK; School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland.
    Chaboyer, Wendy
    School of Nursing & Midwifery, Menzies Health Institute Queensland, Griffith University and Gold Coast Hospital and Health Service, Southport Qld, Australia.
    Cuddigan, Janet
    College of Nursing, University of Nebraska Medical Center, Omaha NE, USA.
    Moore, Zena
    Royal College of Surgeons in Ireland, Dublin, Ireland; Monash University, Melbourne, Australia; Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Lida Institute, Shanghai, China; Cardiff University, Cardiff, Wales.
    Rutherford, Claudia
    Faculty of Science, Quality of Life Office, School of Psychology, University of Sydney, Sydney, Australia; Sydney Nursing School, Cancer Nursing Research Unit (CNRU), University of Sydney, Sydney, Australia.
    Schmitt, Jochen
    Centre for Evidence-based Healthcare, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany.
    Nixon, Jane
    Institute of Clinical Trials Research, Clinical Trials Research Unit, University of Leeds, Leeds, UK.
    Balzer, Katrin
    Institute of Clinical Trials Research, Clinical Trials Research Unit, University of Leeds, Leeds, UK; Institute for Social Medicine and Epidemiology, Nursing Research Unit, University of Lübeck, Lübeck, Germany.
    Outcomes for Pressure Ulcer Trials (OUTPUTs): protocol for the development of a core domain set for trials evaluating the clinical efficacy or effectiveness of pressure ulcer prevention interventions2019In: Trials, ISSN 1745-6215, E-ISSN 1745-6215, Vol. 20, article id 449Article in journal (Refereed)
    Abstract [en]

    Background: Core outcome sets (COS) are being developed in many clinical areas to increase the quality and comparability of clinical trial results as well as to ensure their relevance for patients. A COS represents an agreed standardized set of outcomes that describes the minimum that should be consistently reported in all clinical trials of a defined area. It comprises a core domain set (defining what core outcomes should be measured) and a core measurement set (defining measurement/assessment instruments for each core domain). For pressure ulcer prevention trials a COS is lacking. The great heterogeneity of reported outcomes in this field indicates the need for a COS.

    Methods/design: The first part of this project aims to develop a core domain set by following established methods, which incorporates four steps: (1) definition of the scope, (2) conducting a scoping review, (3) organizing facilitated workshops with service users, (4) performing Delphi surveys and establishing consensus in a face-to-face meeting with different stakeholders.

    Discussion: After achieving consensus on the core domain set, further work will be undertaken to determine a corresponding core measurement set. This will lead to better pressure ulcer prevention research in the future. There are a number of methodological challenges in the field of COS development. To meet these challenges and to ensure a high-quality COS, the OUTPUTS project affiliates to current standards and works in close collaboration with international experts and with existing international service user groups.

    Trial registration: The OUTPUTs project is registered in the COMET database: (http://www.comet-initiative.org/studies/details/283). Registered on 2015.

  • 27.
    Manderlier, Bénédicte
    et al.
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
    Van Damme, Nele
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
    Verhaeghe, Sofie
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department Health Care, VIVES University College, Roeselare, Belgium.
    Van Hecke, Ann
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
    Everink, Irma
    Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.
    Halfens, Ruud
    Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; School of Nursing & Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
    Modifiable patient-related factors associated with pressure ulcers on the sacrum and heels: secondary data analyses2019In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 75, no 11, p. 2773-2785Article in journal (Refereed)
    Abstract [en]

    AIM: To explore factors associated with the presence of category I-IV pressure ulcers on the sacrum and heels.

    DESIGN: Cross-sectional, secondary data analysis using data collected from the Landelijke Prevalentiemeting Zorgproblemen (LPZ) project, a multicentre prevalence study including nursing home residents and community care clients (N = 4842) in the Netherlands in 2017.

    METHODS: A single binary logistic regression model was designed to identify factors associated with the presence of pressure ulcers. Additionally, a multiple binary logistic regression model including modifiable explanatory factors associated with the presence of pressure ulcers was designed.

    RESULTS: Impaired mobility, friction and shear (evaluated using the Braden Scale) are significantly associated with the presence of both sacral and heel category I-IV pressure ulcers. Incontinence-associated dermatitis is significantly associated with category I-IV sacral pressure ulcers.

    CONCLUSION: In pressure ulcer prevention, nursing interventions should focus on frequent repositioning and mobilisation while avoiding exposure of the skin to friction and shear. The need to consider incontinence-associated dermatitis, incontinence and moisture as important factors in pressure ulcer risk assessment is confirmed.

    IMPACT: Pressure ulcers occur when skin and tissues are deformed between bony prominences and the support surface in a sitting or lying position. They are the result of a complex interaction between direct causal factors and a wide range of indirect factors. Recognition of these factors influence risk assessment guidance and practice. Knowledge of skin-specific factors at the patient level, modifiable by nursing interventions, enable a better targeted and tailored preventive approach.

  • 28.
    Petosic, Antonija
    et al.
    Department of Postoperative and Intensive Care, Oslo University Hospital, Oslo, Norway; Institute of Health and Society, University of Oslo, Oslo, Norway.
    Sunde, Kjetil
    Department of Anaesthesiology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
    Beeckman, Dimitri
    Ghent University, Ghent, Belgium.
    Flaatten, Hans K
    University of Bergen, Bergen, Norway.
    Wøien, Hilde
    Department of Postoperative and Intensive Care, Oslo University Hospital, Oslo, Norway; Institute of Health and Society, University of Oslo, Oslo, Norway.
    Use of social media for communicating about critical care topics: A Norwegian cross-sectional survey2019In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 63, no 10, p. 1398-1405Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Social media (SoMe) might be an alternative platform for communicating critical care topics to implement evidence-based practice in the intensive care unit (ICU). This survey aims to describe ICU nurses' and physicians' use of SoMe in general, and their perception of using closed Facebook-groups for receiving content on critical care topics.

    METHODS: A cross-sectional, web-based, anonymous survey was distributed to ICU physicians and nurses in four ICUs in autumn 2017 via an email-campaign. Descriptive statistics with rates, percentages and median numeric rating scale (NRS) scores, interquartile ranges are presented.

    RESULTS: The response-rate was 64% (253/ 394) including 210 nurses and 43 physicians. Overall, 93% had a SoMe-profile, and 77% had a profile on more than one network site. Facebook was the most used social network site, with 87% having a profile. Totally, 68% were daily users, but more nurses used Facebook daily vs physicians (81% vs 60%, respectively, P = 0.006). Nurses were also more positive toward being members of closed Facebook-groups aimed to exchange content on critical care topics (median NRS 9 (6-10) vs 6 (3-9), respectively, P = 0.014).

    CONCLUSION: The majority of ICU nurses and physicians were active SoMe users, mainly for personal purposes, and Facebook was the most popular SoMe. Nurses used Facebook daily more frequent and were more positive toward content on critical care topics on Facebook than physicians. These findings might be relevant to customize future communication about critical care topics via SoMe.

  • 29.
    Prinsen, Cecilia A C
    et al.
    Amsterdam UMC, Department of Epidemiology and Biostatistics, Vrije Universiteit University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
    Spuls, Phyllis I
    Amsterdam UMC, Department of Dermatology, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, the Netherlands.
    Kottner, Jan
    Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany; University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
    Thomas, Kim S
    Centre of Evidence-Based Dermatology, University of Nottingham, Nottingham, United Kingdom.
    Apfelbacher, Christian
    Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
    Chalmers, Joanne R
    Centre of Evidence-Based Dermatology, University of Nottingham, Nottingham, United Kingdom.
    Deckert, Stefanie
    Center for Evidence-Based Healthcare, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
    Furue, Masutaka
    Department of Dermatology, Kyushu University, Fukuoka, Japan.
    Gerbens, Louise
    Amsterdam UMC, Department of Dermatology, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, the Netherlands.
    Kirkham, Jamie
    Medical Research Council North West Hub for Trials Methodology Research, Department of Biostatistics, University of Liverpool, Liverpool, United Kingdom.
    Simpson, Eric L
    Department of Dermatology, Oregon Health & Science University, Portland, Oregon.
    Alam, Murad
    Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
    Balzer, Katrin
    Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany.
    Beeckman, Dimitri
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
    Eleftheriadou, Viktoria
    Centre of Evidence-Based Dermatology, University of Nottingham, Nottingham, United Kingdom.
    Ezzedine, Khaled
    Department of Dermatology and Evaluation of Therapeutics, EA7379, Paris-Est University, University Paris Est Créteil, University Hospital Departments Viruses, Immunity, and Cancer, Créteil, France.
    Horbach, Sophie E R
    Amsterdam UMC, Department of Plastic, Reconstructive, and Hand Surgery, University of Amsterdam, Amsterdam, the Netherlands.
    Ingram, John R
    Division of Infection and Immunity, University Hospital of Wales, Cardiff University, Cardiff, United Kingdom.
    Layton, Alison M
    Hull York Medical School, University of York, York, United Kingdom; Harrogate and District National Health Service Foundation Trust, Harrogate, United Kingdom.
    Weller, Karsten
    Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany.
    Wild, Thomas
    Department of Plastic, Aesthetic, and Hand Surgery, Interdisciplinary Center for Treatment of Chronic Wounds, Dessau Medical Center, Dessau, Germany; Department of Dermatology, Venereology, Allergology, and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany; Institut of Applied Bio-Sciences and Process Management, University of Applied Science Anhalt, Koethen, Germany.
    Wolkerstorfer, Albert
    Amsterdam UMC, Department of Dermatology, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, the Netherlands.
    Williams, Hywel C
    Centre of Evidence-Based Dermatology, University of Nottingham, Nottingham, United Kingdom.
    Schmitt, Jochen
    Center for Evidence-Based Healthcare, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
    Navigating the landscape of core outcome set development in dermatology.2019In: The Journal of American Academy of Dermatology, ISSN 0190-9622, E-ISSN 1097-6787, Vol. 81, no 1, p. 297-305, article id S0190-9622(19)30423-2Article in journal (Refereed)
    Abstract [en]

    The development of core outcome sets (COSs; ie, a minimum set of core outcomes that should be measured and reported in all trials or in clinical practice for a specific condition) in dermatology is increasing in pace. A total of 44 dermatology-related COS projects have been registered in the online Core Outcome Measures in Effectiveness Trials database (http://www.comet-initiative.org/studies/search) and include studies on 26 different skin diseases. With the increasing number of COSs in dermatology, care is needed to ensure the delivery of high-quality COSs that meet quality standards when using state-of-the-art methods. In 2015, the Cochrane Skin-Core Outcome Set Initiative (CS-COUSIN) was established. CS-COUSIN is an international, multidisciplinary working group aiming to improve the development and implementation of COSs in dermatology. CS-COUSIN has developed guidance on how to develop high-quality COSs for skin diseases and supports dermatology-specific COS initiatives. Currently, 17 COS development groups are affiliated with CS-COUSIN and following standardized COS development processes. To ensure successful uptake of COSs in dermatology, researchers, clinicians, systematic reviewers, guideline developers, and other stakeholders should use existing COSs in their work.

  • 30.
    Riviere, M.
    et al.
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department Health Care, VIVES University College, Roeselare, Belgium; AZ Delta, General Hospital, Roeselare, Belgium.
    Dufoort, H.
    AZ Delta, General Hospital, Roeselare, Belgium.
    Van Hecke, A.
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
    Vandecasteele, T.
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department Health Care, VIVES University College, Roeselare, Belgium.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Belgium; School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
    Verhaeghe, S
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department Health Care, VIVES University College, Roeselare, Belgium.
    Core elements of the interpersonal care relationship between nurses and older patients without cognitive impairment during their stay at the hospital: A mixed-methods systematic review2019In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 92, p. 154-172Article, review/survey (Refereed)
    Abstract [en]

    BACKGROUND: The fundamental importance of establishing an interpersonal care relationship for quality nursing care has been highlighted. However specific elements of the interpersonal care relationship of importance to older patients in the hospital have not been identified.

    OBJECTIVES: The aim of this review was to explore and synthesise research findings regarding the elements of the interpersonal care relationship concept from the perspectives of older patients.

    DESIGN: A systematic mixed-methods review.

    DATA SOURCES: An extensive search was conducted up until October 2018 for articles without any publication date time limit in PubMed, Web of Science, Cochrane Database of Systematic Reviews and CINAHL.

    REVIEW METHODS: Primary studies were included if they concerned patients aged 65 years or older and their perspectives on the elements of the interpersonal care relationship with nurses. Inclusion was limited to patients without cognitive impairment who were admitted to an acute hospital setting. The methodological quality of each study was assessed using the Critical Appraisal Skills Programme for qualitative studies, the Quality Assessment Tool for Quantitative Studies and the Mixed-Methods Appraisal Tool. Thematic analysis was used to structure the results of the included studies.

    RESULTS: Of the 7596 studies found, 24 were included in this review. Twenty articles had a qualitative, three a quantitative and one a mixed methods design. Older patients consider dignity and respect as core values that need to be met in the interpersonal care relationship. Five core elements of the interpersonal care relationship were identified to meet these core values: elements related to caring behaviour and attitude, person-centred care, patient participation, communication and situational aspects. These core elements were structured according to three categories, identified in the literature, that determine the quality of the interpersonal care relationship: nurse-, older-patient-related elements and situational aspects.

    CONCLUSIONS: The elements identified in this review can guide efforts to define the interpersonal care relationship between older patients and nurses. Nurses should be supported and motivated by education and practice to adapt their behaviour, attitudes and communication to meet older patients' expectations. Hospital management can also encourage nurses to communicate well. Investment in the current organisation of care is needed to improve nurses' work overload and presence. Further research is needed to clarify the underlying processes influencing the experience of the interpersonal care relationship from the perspectives of older patients, nurses, informal caregivers and hospital management.

  • 31.
    Serraes, Brecht
    et al.
    Department of Nursing, General Hospital, Sint-Niklaas, Belgium.
    van Leen, Martin
    Martin's Geriatric & Wound Consultancy, Rotterdam, the Netherlands; Faculty of Health, Medicine and Life Sciences, Department of Family Medicine, Maastricht University, Maastricht, Netherlands.
    Schols, Jos
    CAPHRI, Care and Public Health Research Institute, Department of Health Services Research and Department of Family Medicine, Maastricht University, Maastricht, Netherlands.
    Van Hecke, Ann
    Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.
    Verhaeghe, Sofie
    Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.
    Beeckman, Dimitri
    Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.
    Prevention of pressure ulcers with a static air support surface: A systematic review2018In: International Wound Journal, ISSN 1742-4801, E-ISSN 1742-481X, Vol. 15, no 3, p. 333-343Article, review/survey (Refereed)
    Abstract [en]

    The aims of this study were to identify, assess, and summarise available evidence about the effectiveness of static air mattress overlays to prevent pressure ulcers. The primary outcome was the incidence of pressure ulcers. Secondary outcomes included costs and patient comfort. This study was a systematic review. Six electronic databases were consulted: Cochrane Library, EMBASE, PubMed (Medline), CINAHL (EBSCOhost interface), Science direct, and Web of Science. In addition, a hand search through reviews, conference proceedings, and the reference lists of the included studies was performed to identify additional studies. Potential studies were reviewed and assessed by 2 independent authors based on the title and abstract. Decisions regarding inclusion or exclusion of the studies were based on a consensus between the authors. Studies were included if the following criteria were met: reporting an original study; the outcome was the incidence of pressure ulcer categories I to IV when using a static air mattress overlay and/or in comparison with other pressure-redistribution device(s); and studies published in English, French, and Dutch. No limitation was set on study setting, design, and date of publication. The methodological quality assessment was evaluated using the Critical Appraisal Skills Program Tool. Results were reported in a descriptive way to reflect the exploratory nature of the review. The searches included 13 studies: randomised controlled trials (n = 11) and cohort studies (n = 2). The mean pressure ulcer incidence figures found in the different settings were, respectively, 7.8% pressure ulcers of categories II to IV in nursing homes, 9.06% pressure ulcers of categories I to IV in intensive care settings, and 12% pressure ulcers of categories I to IV in orthopaedic wards. Seven comparative studies reported a lower incidence in the groups of patients on a static air mattress overlay. Three studies reported a statistical (P < .1) lower incidence compared with a standard hospital mattress (10 cm thick, density 35 kg/m(3)), a foam mattress (15 cm thick), and a viscoelastic foam mattress (15 cm thick). No significant difference in incidence, purchase costs, and patient comfort was found compared with dynamic air mattresses. This review focused on the effectiveness of static air mattress overlays to prevent pressure ulcers. There are indications that these mattress overlays are more effective in preventing pressure ulcers compared with the use of a standard mattress or a pressure-reducing foam mattress in nursing homes and intensive care settings. However, interpretation of the evidence should be performed with caution due to the wide variety of methodological and/or reporting quality levels of the included studies.

  • 32.
    Shanley, Emer
    et al.
    School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
    Moore, Zena
    School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland; Skin Wounds and Trauma (SWaT) Research Centre, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland; Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia; Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Lida Institute, Shanghai, China; Cardiff University, Cardiff, UK.
    Patton, Declan
    School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
    Connor, Tom O.
    School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
    Avsar, Pinar
    School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
    Nugent, Linda
    School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland; Skin Integrity Research Group (SKINT), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Research Unit of Plastic Surgery, Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; School of Nursing and Midwifery, Monash University, Melbourne, VIC, Australia.
    Development and psychometric evaluation of the patient knowledge of, and attitudes and behaviours towards pressure ulcer prevention instrument (KPUP).2019In: International Wound Journal, ISSN 1742-4801, E-ISSN 1742-481XArticle in journal (Refereed)
    Abstract [en]

    The Patient Knowledge of, and Attitude and Behaviour towards Pressure Ulcer Prevention Instrument (KPUP) was developed and validated using a two-stage prospective psychometric instrument validation study design. In Stage 1, the instrument was designed, and it is psychometrically evaluated in Stage 2. To establish content validity, two expert panels independently reviewed each item for appropriateness and relevance. Psychometric evaluation included construct validity and stability testing of the instrument. The questionnaire was administered to a convenience sample of 200 people aged more than 65 years, living independently in the community; reliability and stability were assessed by test/retest procedures, with a 1-week interval. Mean knowledge scores at 'test' were 11.54/20 (95% CI = 11.10-11.99, SD: 3.07), and 'retest' was 12.24 (95% CI = 11.81-12.66, SD: 2.93). For knowledge, correlation between the test/retest score was positive (r=. 60), attitude section-inter-item correlations ranged from r = -.31 to r = .57 (mean intraclass correlation coefficient of r = .42), and internal consistency for the retest was the same as the test (α = .41 for the eight items). For health behaviours, individual inter-item correlations for test items ranged from r = -.21 to r = .41 for the 13 standardised items. Psychometric testing of the KPUP in a sample of older persons in the community provided moderate internal consistency and general high test-retest stability.

  • 33.
    Smet, Steven
    et al.
    Wound care center, Ghent University Hospital, Ghent, Belgium.
    de Graaf, Annelies
    Nursing Center of excellence, University Hospitals of Leuven, Leuven, Belgium.
    Bernaerts, Kris
    Nursing Center of excellence, University Hospitals of Leuven, Leuven, Belgium.
    Casaer, Michael P
    Clinical Division and Laboratory of Intensive Care Medicine, University Hospitals of Leuven, Leuven, Belgium; Department of Cellular and Molecular Medicine, Catholic University of Leuven, Leuven, Belgium.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland.
    The Belgian pressure ulcer risk assessment project: Is assessing mobility and skin status a more accurate, reliable, and feasible approach to assess pressure ulcer risk in hospitalised patients?2019In: International Wound Journal, ISSN 1742-4801, E-ISSN 1742-481X, Vol. 16, no 6, p. 1577-1578Article in journal (Refereed)
  • 34.
    Taradaj, Jakub
    et al.
    Department of Physiotherapy Basics, Academy of Physical Education, Katowice, Poland; College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada.
    Shay, Barbara
    College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada.
    Dymarek, Robert
    Department of Nervous System Diseases, Wroclaw Medical University, Wroclaw, Poland.
    Sopel, Mirosław
    Department of Nervous System Diseases, Wroclaw Medical University, Wroclaw, Poland.
    Walewicz, Karolina
    Faculty of Physiotherapy, Public Higher Medical Professional School, Opole, Poland.
    Beeckman, Dimitri
    University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium.
    Schoonhoven, Lisette
    Faculty of Health Sciences, University of Southampton, University, Southampton, United Kingdom.
    Gefen, Amit
    Department of Biomedical Engineering, Tel Aviv University, Tel Aviv, Israel.
    Rosińczuk, Joanna
    Department of Nervous System Diseases, Wroclaw Medical University, Wroclaw, Poland.
    Effect of laser therapy on expression of angio- and fibrogenic factors, and cytokine concentrations during the healing process of human pressure ulcers2018In: International Journal of Medical Sciences, ISSN 1449-1907, E-ISSN 1449-1907, Vol. 15, no 11, p. 1105-1112Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate the effect of laser irradiation at different wavelengths on the expression of selected growth factors and inflammatory mediators at particular stages of the wound healing process. Methods: Sixty-seven patients were recruited, treated, and analyzed (group A - 940 nm: 17 patients; group B - 808 nm: 18 patients; group C - 658 nm: 16 patients; group D - sham therapy: 17 patients). Patients received a basic treatment, including repositioning and mobilization, air pressure mattress and bed support surfaces, wound cleansing and drug therapy. Additionally, patients received laser therapy once a day, 5 times a week for 1 month in use of a semiconductor lasers (GaAlAs) which emitted a continuous radiation emission at separate wavelengths of 940 nm (group A), 808 nm (group B) and 658 nm (group C). In group D (sham therapy), laser therapy was applied in the same manner, but the device was off during each session (only the applicator was switched on to scan pressure ulcers using none coherent red visible light). Results: The positive changes in the measured serum (IL-2, IL-6 and TNF-α) and wound tissue (TNF-α, VEGF and TGFβ1) parameters appeared to be connected only with the wavelength of 658 nm. The significant change in pro-inflammatory mediator levels [interleukin 2 (IL-2) with p=0.008 and interleukin 6 (IL-6) with p=0.016] was noticed after two weeks of laser therapy. In the other groups, the inflammation was also reduced, but the process was not as marked as in group C. Similarly, in the case of tumor necrosis factor (TNF-α) concentration, where after two weeks of treatment with irradiation at a wavelength of 658 nm, a rapid suppression was observed (p=0.001), whereas in the other groups, these results were much slower and not as obvious. Interestingly, again in the case of group C, the change in TNF-α concentration in wound tissue was most intensive (≈75% reduction), whereas the changes in other groups were not as obvious (≈50% reduction). After irradiation (658 nm), the VEGF expression increased significantly within the first two weeks, and then it decreased and maintained a stable level. In contrast, the TGFβ1 activity remained level, but always higher in comparison to other groups Conclusions: The effective healing of pressure ulcers is connected with laser irradiation at a wavelength of 658 nm. We believe that this effect is related to the inhibition of inflammatory processes in the wound and stimulation of angiogenesis and fibroblast proliferation at this specific radiation (based both on concentration of interleukins and TNF-α serum level and VEGF, TGFβ1, TNF-α activities in wound biopsies). Laser therapy at wavelengths of 940 and 808 nm does not significantly affect the above-mentioned repair processes, which explains its low effectiveness in the treatment of pressure ulcers.

  • 35.
    Theys, Sofie
    et al.
    Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.
    Lust, Elisa
    Dienstverleningscentrum voor personen met verstandelijke beperkingen vzw Heilig Hart, Deinze, Belgium.
    Heinen, Maud
    Nursing Science and Allied Healthcare, Radboud Institute for Health Sciences, IQ healthcare, Radboud University Medical Center, Nijmegen, The Netherlands.
    Verhaeghe, Sofie
    Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Department Health Care, VIVES University College, Ghent, Belgium.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Skin Integrity Research Group (SKINT), Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.
    Eeckloo, Kristof
    Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent University Hospital, Ghent, Belgium.
    Malfait, Simon
    Ghent University Hospital, Ghent, Belgium.
    Van Hecke, Ann
    Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
    Barriers and enablers for the implementation of a hospital communication tool for patient participation: a qualitative study2019In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To investigate potential barriers and enablers prior to the implementation of the Tell-us card.

    BACKGROUND: Patient participation has the potential to improve quality of care and has a positive effect on health outcomes. In order to enhance participation of patients, adequate communication between patients, their relatives and healthcare professionals is vital. Communication is considered as a fundament of care according to the Fundamentals of Care Framework. A strategy to improve patient participation is the use of the Tell-us card; a communication tool that patients and relatives can use during hospitalization to point out what is important for them during their admission and before discharge. Investigating barriers and enablers is needed before implementation.

    DESIGN: A qualitative study.

    METHODS: Semi-structured, individual interviews with (head)nurses, nurse assistants and midwifes. Interviews were audio-recorded, transcribed and analysed using the framework analysis method. The COREQ checklist has been used.

    RESULTS: The need to maintain control over care, reluctance to engage in in-depth conversations, fear of being seen as unprofessional by patients, fear of repercussions from physicians, the lack of insight in the meaning of patient participation, and the lack of appreciation of the importance of patient participation appeared to be majors barriers. Participants also elaborated on several prerequisites for successful implementation and regarded the cooperation of the multidisciplinary team as an essential enabler.

    CONCLUSION: The identified barriers and enablers revealed that nurses and midwives are rather reluctant towards patient participation and actively facilitating that by using the Tell-us card communication tool.

    RELEVANCE TO CLINICAL PRACTICE: A number of issues will have to be factored into the implementation plan of the communication tool. Tailored implementation strategies will be crucial to overcome barriers and to accomplish a successful and sustainable implementation of the Tell-us card.

  • 36.
    Torsy, Tim
    et al.
    Department of Nursing, Odisee University College, Brussels, Belgium.
    Saman, Renée
    Department of Nursing, Odisee University College, Brussels, Belgium; AZ Nikolaas General Hospital, Sint-Niklaas, Belgium.
    Boeykens, Kurt
    AZ Nikolaas General Hospital, Sint-Niklaas, Belgium.
    Duysburgh, Ivo
    AZ Nikolaas General Hospital, Sint-Niklaas, Belgium.
    Van Damme, Nele
    University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.
    Beeckman, Dimitri
    University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.
    Comparison of Two Methods for Estimating the Tip Position of a Nasogastric Feeding Tube: A Randomized Controlled Trial2018In: Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, E-ISSN 1941-2452, Vol. 33, no 6, p. 843-850Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Several studies have shown that the nose-earlobe-xiphoid distance (NEX) is inadequate to estimate the insertion length of nasogastric tubes. An alternative approach tested in these studies, which leads to > 90% well-placed nasogastric tubes, used a corrected calculation of the NEX: (NEX × 0.38696) + 30.37. The primary aim of this study was to determine whether using the corrected NEX was more successful than the NEX in determining the insertion length. The secondary aim was to investigate the likelihood to successfully obtain gastric aspirate.

    METHODS: Adult patients in a general hospital (N = 215) needing a nasogastric tube were randomized to the control (NEX) or intervention group (corrected NEX). Tip positioning was verified using X-ray. Correct tip positioning was defined as between 3 and 10 cm under the lower esophageal sphincter (LES).

    RESULTS: In >20% of all patients, both methods underestimated the required tube length for correct positioning. The NEX showed an overestimation (17.2%) of the insertion length (>10 cm under the LES) compared with the corrected NEX (4.8%). There was no difference (P = 0.938) between the 2 groups in obtaining gastric aspirate (55.6% vs 56%). However, correct tip positioning resulted in a fourfold increase of obtaining gastric aspirate.

    CONCLUSIONS: Both methods resulted in a high risk of incorrectly placed tubes due to malposition of the tip near the LES or distal esophagus. This may increase the risk of reflux and pulmonary aspiration. Based on these results, the development of more reliable methods requires consideration.

  • 37.
    Van Damme, Nele
    et al.
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium.
    Clays, Els
    Epidemiology and Prevention Unit, Department of Public Health, Ghent University, Ghent, Belgium.
    Verhaeghe, Sofie
    University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium; Department Health Care, VIVES University College, Roeselare, Belgium.
    Van Hecke, Ann
    University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
    Beeckman, Dimitri
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium; School of Health Sciences, University of Surrey, Guilford, UK; School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland.
    Independent risk factors for the development of incontinence-associated dermatitis (category 2) in critically ill patients with fecal incontinence: A cross-sectional observational study in 48 ICU units2018In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 81, p. 30-39, article id S0020-7489(18)30025-7Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Critically ill patients suffering from fecal incontinence have a major risk of developing incontinence-associated dermatitis (IAD). The presence of moisture and digestive enzymes (lipase, protease) negatively influences skin barrier function. Additional risk factors will make some patients even more vulnerable than others. In order to provide (cost) effective prevention, this specific patient population should be identified timely.

    OBJECTIVES: To identify independent risk factors for the development of IAD category 2 (skin loss) in critically ill patients with fecal incontinence.

    DESIGN: A cross-sectional observational study.

    SETTING AND PARTICIPANTS: The study was performed in 48 ICU wards from 27 Belgian hospitals. Patients of 18 years or older, with fecal incontinence at the moment of data collection, were eligible to participate. Patients with persistent skin redness due to incontinence (IAD category 1) were excluded.

    METHODS: and Hosmer-Lemeshow statistic were calculated as measures of model fit.

    RESULTS: was 0.377. The Hosmer-Lemeshow statistic indicated no significant difference between the observed and expected values (p = .301).

    CONCLUSIONS: Liquid stool, diabetes, age, smoking, non-use of diapers, fever, and low oxygen saturation were independently associated with IAD category 2 in critically ill patients with fecal incontinence.

  • 38.
    Van Damme, Nele
    et al.
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Belgium.
    Van Hecke, Ann
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Belgium; Nursing Department, Ghent University Hospital, Belgium.
    Himpens, Annelies
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Belgium.
    Verhaeghe, Sofie
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Belgium; Department of Health Care, VIVES University College, Roeselare, Belgium.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Belgium; School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
    Design and psychometric testing of the attitude towards the prevention of incontinence-associated dermatitis instrument (APrIAD)2019In: International Wound Journal, ISSN 1742-4801, E-ISSN 1742-481X, Vol. 16, no 2, p. 492-502Article in journal (Refereed)
    Abstract [en]

    Despite the availability of a range of skin care products for the prevention of incontinence-associated dermatitis (IAD), prevalence remains high. Nurses' attitude is an important determinant to take into account in quality improvement projects. This study aimed to design a psychometrically test the attitude towards the prevention of incontinence-associated dermatitis instrument (APrIAD). A prospective psychometric instrument validation study was performed in a convenience sample of 217 Belgian nurses. Construct validity and reliability (internal consistency, stability) were tested. The exploratory factor analysis demonstrated a model consisting of four factors and 14 items: (a) beliefs about the impact of IAD on patients, (b) beliefs about team responsibility to prevent IAD, (c) beliefs about personal responsibility to prevent IAD, and (d) beliefs about the effectiveness of IAD prevention products and procedures. Cronbach's α was 0.72 for factor 1, 0.65 for factor 2, 0.63 for factor 3, and 0.47 for factor 4. The intra-class correlation coefficient was 0.689 (95% confidence interval [CI] 0.477-0.825) for the total instrument, 0.591 (95% CI 0.388-0.764) for factor 1, 0.387 (95% CI 0.080-0.626) for factor 2, 0.640 (95% CI 0.406-0.795) for factor 3, and 0.768 (95% CI 0.597-0.872) for factor 4. Psychometric testing of the APrIAD demonstrated adequate validity and reliability measures.

  • 39.
    Van Damme, Nele
    et al.
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium .
    Van Hecke, Ann
    University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium; Nursing department, Ghent University Hospital, Ghent, Belgium.
    Remue, Eline
    University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium.
    Van den Bussche, Karen
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium .
    Moore, Zena
    kin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium; School of Nursing & Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
    Gefen, Amit
    Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Israel.
    Verhaeghe, Sofie
    University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium; Department of Health Care, VIVES University of Applied Sciences, Roeselare, Belgium.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium; School of Nursing & Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland; Research Unit of Plastic Surgery, Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; School of Nursing and Midwifery, Monash University, Melbourne, Australia .
    Physiological processes of inflammation and edema initiated by sustained mechanical loading in subcutaneous tissues: A scoping review2019In: Wound Repair and Regeneration, ISSN 1067-1927, E-ISSN 1524-475XArticle in journal (Refereed)
    Abstract [en]

    Deep tissue injuries are pressure ulcers which initiate in the subcutaneous tissues and extend through a bottom-up pathway. Once deep tissue injuries are visual at skin level, serious irreversible tissue damage has already occurred. In pressure ulcer development, inflammation and edema are coupled physiological processes associated with tissue damage arising due to sustained mechanical loading. This study aimed to provide an in-depth overview of the physiological processes of inflammation and edema initiated by sustained mechanical loading in subcutaneous tissues, in the context of pressure ulceration. A scoping review was performed according to the framework by Arksey and O'Malley. The databases MEDLINE, EMBASE, Web of Science, and Scopus, and the reference lists of included studies were searched for in vivo (animal, human), and in vitro studies matching the study objectives (from inception to 28 May 2018). No restrictions for inclusion were applied for study design, setting, participants, and year of publication. A total of 12 studies were included, varying in study design, sample characteristics, amount and duration of mechanical loads that were applied, follow-up time, and assessment methods. Neutrophil infiltration and edema occur in the subcutaneous tissues nearly immediately after the application of load on soft tissues. The amount of neutrophils and edema increase in the first days after the mechanical insult and decrease once healing has been initiated and no supplementary mechanical load was applied. One study indicated that edema may extend up to the level of the dermo-epidermal junction. Further research should focus on how deep tissue inflammation and edema are reflected into unique tissue changes at skin level, and how abnormal inflammatory responses manifest (e.g. when the nervous system is not functioning normally).

  • 40.
    Van den Bussche, Karen
    et al.
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium.
    Kottner, Jan
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium; Clinical Research Center for Hair and Skin Science, Department of Dermatology, Charité-Universtitätsmedizin, Berlin, Germany.
    Beele, Hilde
    Department of Dermatology, Ghent University Hospital, Ghent, Belgium.
    De Meyer, Dorien
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium.
    Dunk, Ann Marie
    Tissue Viability Unit, Canberra Hospital, ACT Health, Canberra, ACT, Australia.
    Ersser, Steven
    Department of Health Sciences, University of York, York, UK.
    Lange, Toni
    Center for Evidence-Based Healthcare, Medizinsche Fakultät Carl Gustav Carus TU Dresden, Dresden, Germany.
    Petrovic, Mirko
    Department of Geriatrics, Ghent University Hospital, Ghent, Belgium.
    Schoonhoven, Lisette
    Faculty of Health Sciences, University of Southampton, Southampton, UK; Radboud University Medical Center, Scientific Institute for Quality of Healthcare, Nijmegen, The Netherlands.
    Smet, Steven
    Wound Care Center, Ghent University Hospital, Ghent, Belgium.
    Van Damme, Nele
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium.
    Verhaeghe, Sofie
    Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.
    Van Hecke, Ann
    Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
    Beeckman, Dimitri
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium; School of Nursing & Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland.
    Core outcome domains in incontinence-associated dermatitis research2018In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 74, no 7, p. 1605-1617Article in journal (Refereed)
    Abstract [en]

    AIM: To report the development of a core set of outcome domains for clinical research involving adults with incontinence-associated dermatitis or at risk, independently from any geographical location or skin colour.

    BACKGROUND: The management of incontinence-associated dermatitis is important in caring for incontinent patients. The lack of comparability of clinical trial outcomes is a major challenge in the field of evidence-based incontinence-associated dermatitis prevention and treatment. Core outcome sets may therefore be helpful to improve the value of clinical incontinence-associated dermatitis research.

    DESIGN: Systematic literature review, patient interviews and consensus study using Delphi procedure.

    METHODS: A list of outcome domains was generated through a systematic literature review (no date restrictions-April 2016), consultation of an international steering committee and three patient interviews. The project team reviewed and refined the outcome domains prior to starting a three-round Delphi procedure conducted between April-September 2017. The panellists, including healthcare providers, researchers and industry were invited to rate the importance of the outcome domains.

    RESULTS: We extracted 1,852 outcomes from 244 articles. Experts proposed 56 and patients 32 outcome domains. After refinement, 57 panellists from 17 countries rated a list of 58 outcome domains. The final list of outcome domains includes erythema, erosion, maceration, IAD-related pain and patient satisfaction.

    CONCLUSION: Erythema, erosion, maceration, incontinence-associated dermatitis -related pain and patient satisfaction are the most important outcome domains to be measured in incontinence-associated dermatitis trials. Based on this international consensus on what to measure, the question of how to measure these domains now requires consideration. Registration: This project has been registered in the Core Outcome Measures in Effectiveness Trials (COMET Initiative) database and is part of the Cochrane Skin Group-Core Outcomes Set Initiative (CSG-COUSIN).

  • 41.
    Van den Bussche, Karen
    et al.
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Belgium.
    Verhaeghe, Sofie
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Belgium; Department Health Care, VIVES University College, Roeselare, Belgium.
    Van Hecke, Ann
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Belgium; School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Ireland.
    Minimum Data Set for Incontinence-Associated Dermatitis (MDS-IAD) in adults: Design and pilot study in nursing home residents2018In: Journal of Tissue Viability, ISSN 0965-206X, Vol. 27, no 4, p. 191-198Article in journal (Refereed)
    Abstract [en]

    Study aim: The aim of this study was to develop a Minimum Data Set for Incontinence-Associated Dermatitis (MDS-IAD), to psychometrically evaluate and pilot test the instrument in nursing homes. Comparable to the MDS for pressure ulcers, the MDS-IAD aims to collect epidemiological data and evaluate the quality of care.

    Materials and methods: After designing and content/face validation by experts and clinicians, staff nurses assessed 108 residents (75.9% female, 77.8% double incontinent) in a convenience sample of five wards. A second nurse independently assessed fifteen residents to calculate inter-rater agreement (p0) and reliability [Cohen's Kappa (ĸ)].

    Results: The ĸ-value for ‘urinary incontinence’ was 0.68 [95% confidence interval (CI) 0.37–0.99] and 0.55 (95% CI 0.27–0.82) for ‘faecal incontinence’. The p0 for severity categorisation according to the Ghent Global IAD Categorisation Tool (GLOBIAD) was 0.60. IAD was diagnosed in 21.3% of the residents. IAD management mainly involved the application of a leave-on product (66.7%), no-rinse foams (49.1%), toilet paper (47.9%), and water and soap (38.8%). Fully adequate prevention or treatment was provided to respectively 3.6% and 8.7% of the residents.

    Conclusion: This instrument provides valuable insights in IAD prevalence at organisational level, will allow benchmarking between organisations, and will support policy makers. Future testing in other healthcare settings is recommended.

  • 42.
    Van den Bussche, Karen
    et al.
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium.
    Verhaeghe, Sofie
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium; Department Health Care, VIVES University College, Roeselare, Belgium.
    Van Hecke, Ann
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
    Beeckman, Dimitri
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium; School of Nursing & Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
    The Ghent Global IAD Monitoring Tool (GLOBIAD-M) to monitor the healing of incontinence-associated dermatitis (IAD): Design and reliability study2018In: International Wound Journal, ISSN 1742-4801, E-ISSN 1742-481X, Vol. 15, no 4, p. 555-564Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to design and evaluate the reliability of the Ghent Global incontinence-associated dermatitis (IAD) Monitoring Tool (GLOBIAD-M). The tool was designed based on the internationally validated Ghent Global IAD Categorisation Tool (GLOBIAD). After designing and validation by experts, one trained researcher carried out 36 observations of 9 patients affected with IAD. Photographs of the IAD lesions were independently assessed by a second trained researcher. Measures for inter-rater agreement (po ) and reliability [Cohen's Kappa (ĸ) and intra-class correlation coefficients (ICC)] were analysed. The po ranged between 0.86 for the item 'maceration' and 0.97 for the item 'clinical signs of infection'. The ĸ for the item 'GLOBIAD classification' was 0.61 [95% confidence interval (CI) 0.28-0.95] and 0.72 (95% CI 0.50-0.95) for 'maceration'. The lowest ĸ was found for the item 'oedema' (0.27; 95% CI -0.24-0.79). The ICC of the item 'redness' was 0.83 (95% CI 0.69-0.91) and 0.87 (95% CI 0.76-0.93) for 'skin loss'. The inter-rater agreement and reliability of the GLOBIAD-M appears to be good for the assessment of photographs by experts. This tool could support clinical decision-making for IAD treatment. Further validation with clinicians is, however, needed.

  • 43.
    Van Hecke, Ann
    et al.
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
    Duprez, Veerle
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
    Pype, Peter
    General Practice Medicine, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; End-of-Life Care Research Group, Ghent University & Vrije Universiteit Brussel (VUB), Ghent, Belgium.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; School of Nursing & Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
    Verhaeghe, Sofie
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department of Nursing, VIVES University College, Roeselare, Belgium.
    Criteria for describing and evaluating training interventions in healthcare professions - CRe-DEPTH2020In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 84, article id 104254Article in journal (Refereed)
    Abstract [en]

    Background: Descriptions of training intervention in healthcare include a lot of vagueness, leaving the reader in doubt about the intervention and the true value of the reported effects. A set of reporting criteria to improve the transparency and comprehensiveness in reporting training interventions in healthcare is recommended.

    Objective: This study aimed to develop and content validate a set of reporting criteria for the development and evaluation of training interventions for healthcare professionals.

    Method: The set of criteria was developed along three stages: (1) a literature review, (2) the design of the criteria, and (3) a Delphi and consensus meeting process with ten experts from different professional disciplines.

    Results: The Criteria for Reporting on Development and Evaluation of Professional Training interventions in Healthcare (CRe-DEPTH) set was systematically developed and consisted of 12 items representing four categories: (1) development of the training, (2) characteristics of the training, (3) characteristics of the providers, and (4) assessment of the training outcomes. Each item has a detailed description to support its unambiguous interpretation.

    Conclusions: The developed CRe-DEPTH reporting criteria guide high quality development, evaluation and reporting for complex training interventions, while preserving the flexibility to incorporate various teaching content or teaching methods. The Cre-DEPTH criteria will allow for detailed reporting on the training, its developmental process, as well as on the rationale for underlying choices, and will avoid non-reporting of training details.

  • 44.
    Van Hecke, Ann
    et al.
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
    Goemaes, Regine
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.
    Verhaeghe, Sofie
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Department Health Care, VIVES University College, Roeselare, Belgium.
    Beyers, Wim
    Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium.
    Decoene, Elsie
    Cancer Centre, Ghent University Hospital, Ghent, Belgium.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Department of Public Health and Primary Care, Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Ireland.
    Leadership in nursing and midwifery: Activities and associated competencies of advanced practice nurses and midwives2019In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 27, no 6, p. 1261-1274Article in journal (Refereed)
    Abstract [en]

    Aim: To explore the practice profile and competencies of advanced practice nurses (APNs) and midwives (AMPs), and factors associated with task non-execution.

    Background: Advanced practitioner roles are increasingly implemented internationally. Unofficial role introduction led to confusion regarding task performance. Studies examining associations between APNs'/AMPs' task performance and competency levels, and factors associated with task non-execution are lacking.

    Method: A cross-sectional study among APNs/AMPs in Flanders (Belgium) explored tasks and competencies in seven domains: clinical/professional leadership, change management/innovation, research, clinical expertise/guidance/coaching, consultation/consultancy, multidisciplinary cooperation/care coordination and ethical decision-making. Task performance and competency level frequencies were calculated. Regression analysis identified factors associated with task non-execution on domain/item level.

    Results: Participants (n = 63) executed tasks in all domains. Task non-execution related to research and clinical expertise was associated with work setting; task non-execution regarding care coordination and ethical decision-making was associated with competency perception. Several tasks were performed by few APNs/AMPs despite many feeling competent. Five of ten tasks performed by fewest participants belonged to the leadership domain.

    Conclusion and implications for nursing and midwifery management: Supervisors could play an important part in APNs'/AMPs' role development, especially regarding leadership and tasks executed by few participants. Future studies should provide in-depth knowledge on task non-execution.

  • 45.
    Van Lancker, Aurélie
    et al.
    University Centre for Nursing and Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
    Van Hecke, Ann
    University Centre for Nursing and Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
    Verhaeghe, Sofie
    University Centre for Nursing and Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
    Mattheeuws, Matthias
    University Centre for Nursing and Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
    Beeckman, Dimitri
    University Centre for Nursing and Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
    A comparison of symptoms in older hospitalised cancer and non-cancer patients in need of palliative care: a secondary analysis of two cross-sectional studies2018In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 18, no 1, article id 40Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Evidence on the differences in symptom patterns between older palliative cancer and non-cancer patients is lacking. The purpose of the study was to determine the differences in symptoms between older hospitalised palliative cancer and non-cancer patients.

    METHODS: A secondary analysis of two multi-centre cross-sectional studies was performed. A validated instrument was used to assess the frequency and intensity of 40 symptoms in older hospitalised palliative cancer patients (n = 100) and older palliative non-cancer patients (n = 100). The data were collected between March 2013 and June 2015. Differences between groups were measured statistically.

    RESULTS: Overall, similarities in symptom patterns were observed between cancer and non-cancer patients. Some minor differences were detected between the groups. Non-cancer patients experienced significantly more physical symptoms and functional dependence than cancer patients. Patients with cancer experienced higher levels of frequency and intensity of psychological symptoms compared to non-cancer patients.

    CONCLUSIONS: Healthcare professionals should be aware of the high occurrence of symptoms in both cancer and non-cancer patients, and they should be educated about the systematic assessment of symptoms in multiple domains by accounting for the occurrence of generic symptoms and disease-specific symptoms.

  • 46.
    Van Tiggelen, H.
    et al.
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
    LeBlanc, K.
    School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada; Wound Ostomy Continence Institute/ Association of Nurses Specialized in Wound Ostomy Continence, Canada.
    Campbell, K.
    School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada.
    Woo, K.
    School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada.
    Baranoski, S.
    Nursing Advisory Board, Rasmussen College, Romeoville/Joliet, Illinois, USA.
    Chang, Y. Y.
    Division of Nursing, Speciality Nursing (Wound Care), Singapore General Hospital, Bukit Merah, Singapore.
    Dunk, A. M.
    Tissue Viability Unit, Canberra Hospital, Canberra Health Services, Canberra, Australia; School of Nursing, Faculty of Health, University of Canberra, Canberra, Australia.
    Gloeckner, M.
    UnityPoint Health Trinity, Rock Island, Illinois & Bettendorf, Iowa, USA.
    Hevia, H.
    Nursing School, Nursing Department, Andrés Bello University, Viña del Mar, Chile.
    Holloway, S.
    Centre for Medical Education, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, Wales, UK.
    Idensohn, P.
    CliniCare Medical Centre, KwaZulu-Natal, Ballito, South Africa; School of Medicine, College of Biomedical and Life Sciences, Cardiff University, Wales, UK; School of Nursing, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
    Karadağ, A.
    School of Nursing, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
    Koren, E.
    Leumit HMO, Vascular Ulcer Clinic, Geula, Jerusalem, Israel; Israeli Wound Care Management and Research Association (IWCMRA), Israel.
    Kottner, J.
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany.
    Langemo, D.
    College of Nursing, University of North Dakota, Grand Forks, North Dakota, USA; Langemo and Associates, Grand Forks, North Dakota, USA.
    Ousey, K.
    Institute of Skin Integrity and Infection Prevention, Department of Nursing and Midwifery, University of Huddersfield, UK; School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia; School of Nursing & Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
    Pokorná, A.
    Department of Nursing, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
    Romanelli, M.
    Department of Dermatology, University of Pisa, Pisa, Italy.
    Santos, V. L. C. G.
    School of Nursing, Medical-Surgical Nursing Department, University of São Paulo, São Paulo, Brazil; of Nursing, Portuguese Catholic University, Porto, Portugal.
    Smet, S.
    Wound Care Center, Ghent University Hospital, Ghent, Belgium.
    Tariq, G.
    Wound Care Unit, Sheikh Khalifa Medical City (SKMC), Abu Dhabi, United Arab Emirates.
    Van den Bussche, K.
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
    Van Hecke, A.
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
    Verhaeghe, S.
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department Health Care, VIVES University College, Roeselare, Belgium.
    Vuagnat, H.
    Centre for Wounds and Wound Healing, University Hospitals of Geneva, Geneva, Switzerland.
    Williams, A.
    Wound and Ostomy Care, Reston Hospital Center, Reston, VA, USA.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; School of Nursing & Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland; Research Unit of Plastic Surgery, Department of Clinical Research, Faculty of Health Sciences, Southern Denmark; School of Nursing and Midwifery, Monash University, Australia.
    Standardising the classification of skin tears: validity and reliability testing of the International Skin Tear Advisory Panel (ISTAP) Classification System in 44 countries2019In: British Journal of Dermatology, ISSN 0007-0963, E-ISSN 1365-2133Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Skin tears are acute wounds that are frequently misdiagnosed and underreported. A standardised and globally adopted skin tear classification system with supporting evidence for diagnostic validity and reliability is required to allow assessment and reporting in a consistent way.

    OBJECTIVES: To measure the validity and reliability of the International Skin Tear Advisory Panel (ISTAP) Classification System internationally.

    METHODS: A multi-country study was set up to validate the content of the ISTAP Classification System through expert consultation in a two-round Delphi procedure involving 17 experts from 11 countries. An online survey including 24 skin tear photographs was conducted in a convenience sample of 1601 healthcare professionals from 44 countries to measure diagnostic accuracy, agreement, inter-rater reliability, and intra-rater reliability of the instrument.

    RESULTS: A definition for the concept of a "skin flap" in the area of skin tears was developed and added to the initial ISTAP Classification System consisting of three skin tear types. The overall agreement with the reference standard was 0.79 (95% CI 0.79-0.80) and sensitivity ranged from 0.74 (95% CI 0.73-0.75) to 0.88 (95% CI 0.87-0.88). The inter-rater reliability was 0.57 (95% CI 0.57-0.57). The Cohen's Kappa measuring intra-rater reliability was 0.74 (95% CI 0.73-0.75).

    CONCLUSIONS: The ISTAP Classification System is supported by evidence for validity and reliability. The ISTAP Classification System should be used for a systematic assessment and reporting of skin tears in clinical practice and research globally.

  • 47.
    Van Tiggelen, Hanne
    et al.
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
    Van Damme, Nele
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
    Theys, Sofie
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
    Vanheyste, Eline
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
    Verhaeghe, Sofie
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department Health Care, VIVES University College, Roeselare, Belgium.
    LeBlanc, Kimberly
    School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada; KDS Professional Consulting, Ottawa, Ontario, Canada.
    Campbell, Karen
    School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada.
    Woo, Kevin
    School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, Ontario.
    Van Hecke, Ann
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; School of Nursing & Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
    The prevalence and associated factors of skin tears in Belgian nursing homes: A cross-sectional observational study2019In: Journal of tissue viability, ISSN 0965-206X, Vol. 28, no 2, p. 100-106Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Although skin tears are among the most prevalent acute wounds in nursing homes, their recognition as a unique condition remains in its infancy. Elderly patients are at risk of developing skin tears due to increased skin fragility and other contributing risk factors. In order to provide (cost-) effective prevention, patients at risk should be identified in a timely manner.

    OBJECTIVES: (1) To determine the point prevalence of skin tears and (2) to identify factors independently associated with skin tear presence in nursing home residents.

    METHODS: A cross-sectional observational study was set up, including 1153 residents in 10 Belgian nursing homes. Data were collected by trained researchers and study nurses using patient records and skin observations. A multiple binary logistic regression model was designed to explore independent associated factors (significance level α < 0.05).

    RESULTS: The final sample consisted of 795 nursing home residents, of which 24 presented with skin tears, resulting in a point prevalence of 3.0%. Most skin tears were classified as category 3 (defined as complete flap loss) according to the International Skin Tear Advisory Panel (ISTAP) Classification System and 75.0% were located on the lower arms/legs. Five independent associated factors were identified: age, history of skin tears, chronic use of corticosteroids, dependency for transfers, and use of adhesives/dressings.

    CONCLUSIONS: This study revealed a skin tear prevalence of 3.0% in nursing home residents. Age, history of skin tears, chronic use of corticosteroids, dependency for transfers, and use of adhesives/dressings were independently associated with skin tear presence.

  • 48.
    Vandewalle, Joeri
    et al.
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, BELGIUM; Research Foundation-Flanders (FWO), Brussel, BELGIUM.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, BELGIUM; School of Nursing and Midwifery, Royal College of Surgeons in Ireland, IRELAND.
    Van Hecke, Ann
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, BELGIUM; Nursing Department, Ghent University Hospital, BELGIUM.
    Debyser, Bart
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, BELGIUM; Department of Nursing, VIVES University College, BELGIUM; Centre for Psychiatry and Psychotherapy Clinic St Joseph, Psychiatric Hospital, BELGIUM.
    Deproost, Eddy
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, BELGIUM; Centre for Psychiatry and Psychotherapy Clinic St Joseph, Psychiatric Hospital, BELGIUM.
    Verhaeghe, Sofie
    University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, BELGIUM; Department of Nursing, VIVES University College, BELGIUM; Department of Nursing, VIVES University College, BELGIUM.
    Contact and communication with patients experiencing suicidal ideation: a qualitative study of nurses' perspectives2019In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 75, no 11, p. 2867-2877Article in journal (Refereed)
    Abstract [en]

    AIM: To uncover and understand the core elements of how nurses in psychiatric hospitals make contact with patients experiencing suicidal ideation.

    DESIGN: A qualitative study based on the principles of grounded theory was performed.

    METHODS: Nineteen nurses on wards of four psychiatric hospitals were interviewed between May 2017 and February 2018. The Qualitative Analysis Guide of Leuven was used to facilitate the constant comparison of data.

    FINDINGS: Nurses make contact with patients experiencing suicidal ideation by 'creating conditions for open and genuine communication' while maintaining a focus on 'developing an accurate and meaningful picture of patients'. These interconnected core elements represent nurses' attention to relational processes like building trust as well as their predominant focus on assessing suicide risk. Nurses put other emphases in their contacts with patients depending on whether their approach is guided more by checking and controlling suicide risk or by acknowledging and connecting (with) the person.

    CONCLUSION: The study enhances the conceptual understanding of how nurses on psychiatric wards can involve in compassionate and considerate contact and communication with patients experiencing suicidal ideation. These findings can be used to underpin the nurses' role in and contribution to suicide prevention.

    IMPACT: The core elements 'creating conditions for open and genuine communication' while maintaining a focus on 'developing an accurate and meaningful picture of patients' can inform policies for nursing practice and education that aim to preserve and improve the capacity of nurses to involve in compassionate and considerate contact and communication with patients experiencing suicidal ideation.

  • 49.
    Vandewalle, Joeri
    et al.
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Research Foundation-Flanders (FWO), Brussels, Belgium.
    Beeckman, Dimitri
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Skin Integrity Research Group (SKINT), Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.
    Van Hecke, Ann
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
    Debyser, Bart
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Department of Nursing, VIVES University College, Roeselare, Belgium; Centre for Psychiatry and Psychotherapy Clinic St Joseph, Psychiatric Hospital, Pittem, Belgium.
    Deproost, Eddy
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Centre for Psychiatry and Psychotherapy Clinic St Joseph, Psychiatric Hospital, Pittem, Belgium.
    Verhaeghe, Sofie
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Department of Nursing, VIVES University College, Roeselare, Belgium.
    'Promoting and preserving safety and a life-oriented perspective': A qualitative study of nurses' interactions with patients experiencing suicidal ideation2019In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 28, no 5, p. 1119-1131Article in journal (Refereed)
    Abstract [en]

    Suicide prevention is an important imperative in psychiatric hospitals, where nurses have a crucial role in and make essential contributions to suicide prevention and promoting the recovery of patients experiencing suicidal ideation. The present qualitative grounded theory study aimed to uncover and understand the actions and aims of nurses in psychiatric hospitals during their interactions with patients experiencing suicidal ideation. Interviews were conducted with 26 nurses employed on 12 wards in four psychiatric hospitals. The data analysis was inspired by the Qualitative Analysis Guide of Leuven. The findings show that nurses' actions and aims in their interactions with patients experiencing suicidal ideation are captured in the core element 'promoting and preserving safety and a life-oriented perspective'. This core element represents the three interconnected elements 'managing the risk of suicide', 'guiding patients away from suicidal ideation', and 'searching for balance in the minefield'. The enhanced understanding of nurses' actions and aims can inform concrete strategies for nursing practice and education. These strategies should aim to challenge overly controlling and directing nursing approaches and support nurses' capacity and ability to connect and collaborate with patients experiencing suicidal ideation.

  • 50.
    Zwaenepoel, Elien
    et al.
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
    Van Hecke, Ann
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
    Manderlier, Bénédicte
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
    Verhaeghe, Sofie
    Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department Health Care, VIVES University College, Roeselare, Belgium.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; School of Nursing & Midwifery, Royal College of Surgeons, in Ireland (RCSI), Dublin, Ireland; Research Unit of Plastic Surgery, Department of Clinical Research, Faculty of Health Sciences, Southern Denmark, Odense, Denmark; School of Nursing and Midwifery, Monash University, Melbourne, Australia.
    Pressure ulcer Cat. II-IV incidence on the CuroCell S.A.M. PRO powered reactive air support surface in a high-risk population: A multicentre cohort study in 12 Belgian nursing homes2020In: International Wound Journal, ISSN 1742-4801, E-ISSN 1742-481X, Vol. 17, no 1, p. 124-131Article in journal (Refereed)
    Abstract [en]

    The primary objective was to study pressure ulcer (PU) category II-IV (including suspected deep tissue injury and unstageable PUs) cumulative incidence and PU incidence density, in a 30day observation period, associated with the use of the CuroCell S.A.M. PRO powered reactive air support surface in nursing home residents at risk for PU development. Secondary objectives were to study (a) PU category I cumulative incidence and PU incidence density and (b) user (caregivers and residents) experiences and perceptions of comfort associated with the use of the support surface under study. A multicentre cohort study was set up in 37 care units of 12 Belgian nursing homes. The sample consisted of 191 residents at risk of PU development (Braden score ≤ 17). The cumulative PU incidence was 4.7% (n = 9). The PU incidence density was 1.7/1000 observation days (9 PU/5370 days). The experience and perceptions of comfort analysis revealed that the CuroCell S.A.M. PRO powered reactive air support surface was comfortable for daily use. The mode of action and the quietness of the pump function had a positive impact on sleep quality. Patient comfort and sleep quality are essential criteria in the selection of a support surface.

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