5 results on '"Engels, Yvonne"'
Search Results
2. Integrating palliative care in long-term care facilities across Europe (PACE): protocol of a cluster randomized controlled trial of the ‘PACE Steps to Success’ intervention in seven countries
- Author
-
Smets, Tinne, Onwuteaka-Philipsen, Bregje B. D., Miranda, Rose, Pivodic, Lara, Tanghe, Marc, van Hout, Hein, Pasman, Roeline H. R. W., Oosterveld-Vlug, Mariska, Piers, Ruth, Van Den Noortgate, Nele, Wichmann, Anne B., Engels, Yvonne, Vernooij-Dassen, Myrra, Hockley, Jo, Froggatt, Katherine, Payne, Sheila, Szczerbińska, Katarzyna, Kylänen, Marika, Leppäaho, Suvi, Barańska, Ilona, Gambassi, Giovanni, Pautex, Sophie, Bassal, Catherine, Deliens, Luc, Van den Block, Lieve, and on behalf of the PACE trial group
- Published
- 2018
- Full Text
- View/download PDF
3. A framework for cross-cultural development and implementation of complex interventions to improve palliative care in nursing homes: the PACE steps to success programme
- Author
-
Hockley, Jo, Froggatt, Katherine, Van Den Block, Lieve, Onwuteaka-Philipsen, Bregje, Kylänen, Marika, Szczerbińska, Katarzyna, Gambassi, Giovanni, Pautex, Sophie, Payne, Sheila Alison, Arrue, Borja, Baranska, Ilona, Deliens, Luc, Engels, Yvonne, Finne-Soveri, Harriet, Kijowska, Viola, Ten Koppel, Maud, Mammarella, Federica, Smets, Tinne, Oosterveld-Vlug, Mariska, Pasman, Roeline, Piers, Ruth, Pivodic, Lara, Van Der Steen, Jenny, Van Den Noortgate, Nele, Van Hout, Hein, Wichmann, Anne, Vernooij-Dassen, Myrra, End-of-life Care Research Group, Clinical sciences, Public and occupational health, APH - Aging & Later Life, APH - Quality of Care, and General practice
- Subjects
Cross-Cultural Comparison ,Palliative care ,Alzheimer`s disease Donders Center for Medical Neuroscience [Radboudumc 1] ,GOLD STANDARDS FRAMEWORK ,education ,Psychological intervention ,Social Sciences ,Intervention ,Development ,Health informatics ,Health administration ,PATHWAY ,03 medical and health sciences ,0302 clinical medicine ,Intervention (counseling) ,Medicine and Health Sciences ,Medicine ,Humans ,030212 general & internal medicine ,Pace ,Medical education ,Terminal Care ,Cross-cultural adaptation ,BARRIERS ,business.industry ,Long-term care facilities ,Nursing home ,4. Education ,030503 health policy & services ,Health Policy ,Nursing research ,lcsh:Public aspects of medicine ,lcsh:RA1-1270 ,Long-Term Care ,Quality Improvement ,Nursing Homes ,Europe ,End-of-life care ,Implementation ,ddc:618.97 ,OF-LIFE CARE ,0305 other medical science ,business ,Research Article - Abstract
Background The PACE Steps to Success programme is a complex educational and development intervention to improve palliative care in nursing homes. Little research has investigated processes in the cross-cultural adaptation and implementation of interventions in palliative care across countries, taking account of differences in health and social care systems, legal and regulatory policies, and cultural norms. This paper describes a framework for the cross-cultural development and support necessary to implement such an intervention, taking the PACE Steps to Success programme as an exemplar. Methods The PACE Steps to Success programme was implemented as part of the PACE cluster randomised control trial in seven European countries. A three stage approach was used, a) preparation of resources; b) training in the intervention using a train-the-trainers model; and c) cascading support throughout the implementation. All stages were underpinned by cross-cultural adaptation, including recognising legal and cultural norms, sensitivities and languages. This paper draws upon collated evidence from minutes of international meetings, evaluations of training delivered, interviews with those delivering the intervention in nursing homes and providing and/or receiving support. Results Seventy eight nursing homes participated in the trial, with half randomized to receive the intervention, 3638 nurses/care assistants were identified at baseline. In each country, 1–3 trainers were selected (total n = 16) to deliver the intervention. A framework was used to guide the cross-cultural adaptation and implementation. Adaptation of three English training resources for different groups of staff consisted of simplification of content, identification of validated implementation tools, a review in 2 nursing homes in each country, and translation into local languages. The same training was provided to all country trainers who cascaded it into intervention nursing homes in local languages, and facilitated it via in-house PACE coordinators. Support was cascaded from country trainers to staff implementing the intervention. Conclusions There is little guidance on how to adapt complex interventions developed in one country and language to international contexts. This framework for cross-cultural adaptation and implementation of a complex educational and development intervention may be useful to others seeking to transfer quality improvement initiatives in other contexts.
- Published
- 2019
4. How do GPs identify a need for palliative care in their patients? An interview study.
- Author
-
Claessen, Susanne J. J., Francke, Anneke L., Engels, Yvonne, and Deliens, Luc
- Subjects
TUMOR treatment ,INTERVIEWING ,MEDICAL needs assessment ,PALLIATIVE treatment ,GENERAL practitioners ,RESEARCH funding ,QUALITATIVE research ,NARRATIVES ,DATA analysis software - Abstract
Background: Little is known about how GPs determine whether and when patients need palliative care. Little research has been done regarding the assumption underpinning Lynn and Adamson's model that palliative care may start early in the course of the disease. This study was conducted to explore how GPs identify a need for palliative care in patients. Methods: A qualitative interview study was performed among 20 GPs in the Netherlands. Results: GPs reported that a combination of several signals, often subtle and not explicit, made them identify a need for palliative care: signals from patients (increasing care dependency and not recuperating after intercurrent diseases) and signals from relatives or reports from medical specialists. GPs reported differences in how they identified a need for palliative care in cancer patients versus those with other diseases. In cancer patients, the need for palliative care was often relatively clear because of a relatively strict demarcation between the curative and palliative phase. However, in patients with e.g. COPD or in the very old, GPs' awareness of palliative care needs often arises gradually, relatively late in the disease trajectory. GPs consider the diagnosis of a life-threatening illness as a key point in the disease trajectory. However, this does not automatically mean that a patient needs palliative care at that point. Conclusions: GPs recognize a need for palliative care on the basis of various signals. They do not support the idea underlying Lynn and Adamson's model that palliative care always starts early in the course of the disease. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
5. Improving palliative care in selected settings in England using quality indicators: a realist evaluation
- Author
-
Iliffe, Steve, Davies, Nathan, Manthorpe, Jill, Crome, Peter, Ahmedzai, Sam H, Vernooij-Dassen, Myrra, and Engels, Yvonne
- Subjects
Male ,Alzheimer`s disease Donders Center for Medical Neuroscience [Radboudumc 1] ,Evidence-based practice ,Quality management ,Palliative care ,Referral ,Health Services for the Aged ,media_common.quotation_subject ,Best practice ,Care homes ,Quality indicators ,Patient Care Planning ,Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Electronic Health Records ,Humans ,Medicine ,Quality (business) ,030212 general & internal medicine ,Patient Comfort ,Quality improvement ,Quality Indicators, Health Care ,Quality of Health Care ,Cancer ,media_common ,Medicine(all) ,Terminal Care ,business.industry ,030503 health policy & services ,Medical record ,Hospices ,General Medicine ,Primary care ,3. Good health ,Hospitalization ,England ,Evidence-Based Practice ,Female ,Dementia ,0305 other medical science ,business ,Realist evaluation ,End-of-life care ,Research Article - Abstract
Background There is a gap between readily available evidence of best practice and its use in everyday palliative care. The IMPACT study evaluated the potential of facilitated use of Quality Indicators as tools to improve palliative care in different settings in England. Methods 1) Modelling palliative care services and selecting a set of Quality Indicators to form the core of an intervention, 2) Case studies of intervention using the Quality Indicator set supported by an expert in service change in selected settings (general practice, community palliative care teams, care homes, hospital wards, in-patient hospices) with a before-and-after evaluation, and 3) realist evaluation of processes and outcomes across settings. Participants in each setting were supported to identify no more than three Quality Indicators to work on over an eight-month period in 2013/2014. Results General practices could not be recruited to the study. Care homes were recruited but not retained. Hospital wards were recruited and retained, and using the Quality Indicator (QI) set achieved some of their desired changes. Hospices and community palliative care teams were able to use the QI set to achieve almost all their desired changes, and develop plans for quality improvements. Improvements included: increasing the utility of electronic medical records, writing a manual for end of life care, establishing working relationships with a hospice; standardising information transfer between settings, holding regular multi-disciplinary team meetings, exploration of family carers’ views and experiences; developing referral criteria, and improvement of information transfer at patient discharge to home or to hospital. Realist evaluation suggested that: 1) uptake and use of QIs are determined by organisational orientation towards continuous improvement; 2) the perceived value of a QI package was not powerful enough for GPs and care homes to commit to or sustain involvement; 3) the QI set may have been to narrow in focus, or more specialist than generalist; and 4) the greater the settings’ ‘top-down’ engagement with this change project, the more problematic was its implementation. Conclusions Whilst use of QIs may facilitate improvements in specialist palliative care services, different QI sets may be needed for generalist care settings. Electronic supplementary material The online version of this article (doi:10.1186/s12904-016-0144-1) contains supplementary material, which is available to authorized users.
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.