11 results on '"return to normal activities"'
Search Results
2. Using patient data to optimize an expert-based guideline on convalescence recommendations after gynecological surgery: a prospective cohort study
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Esther V. A. Bouwsma, Johannes R. Anema, A. Vonk Noordegraaf, Henrica C. W. de Vet, and Judith A. F. Huirne
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Convalescence advice ,return to normal activities ,return to work ,hysterectomy ,laparoscopic adnexal surgery ,eHealth ,Surgery ,RD1-811 - Abstract
Abstract Background Convalescence advice is often based on tradition and anecdote from health care providers, rather than being based on experiences from patients themselves. The aim of this study was to analyse recovery in terms of resumption of various daily activities including work, following different laparoscopic and abdominal surgery in order to optimize an expert-based guideline on convalescence recommendations. Methods This is a prospective cohort study conducted in nine general and one university hospital in the Netherlands. Women aged 18–65 years and scheduled for a hysterectomy (laparoscopic, vaginal, abdominal) and/or laparoscopic adnexal surgery (n = 304) were eligible to participate. Preoperatively, participants were provided with tailored expert-based convalescence recommendations on the graded resumption of several daily activities including sitting, standing, walking, climbing stairs, bending, lifting, driving, cycling, household chores, sport activities and return to work (RTW). Postoperatively, time until the resumption of these activities was tracked. Convalescence recommendations were considered correct when at least 25% and less than 50% of the women were able to resume an activity before or at the recommended recovery time. Results There was a wide variation in the duration until the resumption of daily activities within and between groups of patients undergoing different types of surgery. Recovery times lengthened with increasing levels of physical burden as well as with increasing levels of invasiveness of the surgery. For the majority of activities actual recovery times exceeded the recovery time recommended by the expert panel. Conclusions This study provided insight in the resumption of daily activities after gynecological surgery and the adequacy of an expert-based convalescence guideline in clinical practice. Patient data was used to optimize the convalescence recommendations. Trial registration Dutch trial registry, NTR2087 (August 2009) and NTR2933 (June 2011).
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- 2017
- Full Text
- View/download PDF
3. Using patient data to optimize an expert-based guideline on convalescence recommendations after gynecological surgery: a prospective cohort study.
- Author
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Bouwsma, Esther V. A., Anema, Johannes R., Noordegraaf, A. Vonk, de Vet, Henrica C. W., Huirne, Judith A. F., and Vonk Noordegraaf, A
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CONVALESCENCE ,GYNECOLOGIC surgery ,LAPAROSCOPY ,ABDOMINAL surgery ,HYSTERECTOMY ,LONGITUDINAL method ,MEDICAL protocols ,POSTOPERATIVE period ,RESEARCH funding - Abstract
Background: Convalescence advice is often based on tradition and anecdote from health care providers, rather than being based on experiences from patients themselves. The aim of this study was to analyse recovery in terms of resumption of various daily activities including work, following different laparoscopic and abdominal surgery in order to optimize an expert-based guideline on convalescence recommendations.Methods: This is a prospective cohort study conducted in nine general and one university hospital in the Netherlands. Women aged 18-65 years and scheduled for a hysterectomy (laparoscopic, vaginal, abdominal) and/or laparoscopic adnexal surgery (n = 304) were eligible to participate. Preoperatively, participants were provided with tailored expert-based convalescence recommendations on the graded resumption of several daily activities including sitting, standing, walking, climbing stairs, bending, lifting, driving, cycling, household chores, sport activities and return to work (RTW). Postoperatively, time until the resumption of these activities was tracked. Convalescence recommendations were considered correct when at least 25% and less than 50% of the women were able to resume an activity before or at the recommended recovery time.Results: There was a wide variation in the duration until the resumption of daily activities within and between groups of patients undergoing different types of surgery. Recovery times lengthened with increasing levels of physical burden as well as with increasing levels of invasiveness of the surgery. For the majority of activities actual recovery times exceeded the recovery time recommended by the expert panel.Conclusions: This study provided insight in the resumption of daily activities after gynecological surgery and the adequacy of an expert-based convalescence guideline in clinical practice. Patient data was used to optimize the convalescence recommendations.Trial Registration: Dutch trial registry, NTR2087 (August 2009) and NTR2933 (June 2011). [ABSTRACT FROM AUTHOR]- Published
- 2017
- Full Text
- View/download PDF
4. Ergebnisse der laparoskopischen Appendektomie im Vergleich zur konventionellen Operationstechnik
- Author
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Raakow, R., Keck, H., Neuhaus, P., Hartel, W., editor, and Becker, H.-M.
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- 1993
- Full Text
- View/download PDF
5. Electronic Health Program to Empower Patients in Returning to Normal Activities After General Surgical and Gynecological Procedures: Intervention Mapping as a Useful Method for Further Development
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Petrus C. Scholten, Esther Cj Consten, Steve M.M. de Castro, W. Marchien van Baal, Chantal M. den Bakker, Baukje van den Heuvel, Peggy M.A.J. Geomini, Hendrik J. Bonjer, Jan Willem van der Steeg, Steven E. Schraffordt Koops, Paul H. P. Davids, Wilhelmus J. H. J. Meijerink, Frederieke G. Schaafsma, Astrid H Baan, Suzan van der Meij, Hein B A C Stockmann, A. Dorien ten Cate, Eva van der Meij, Judith A.F. Huirne, D.J. Lips, Paul J. M. van Kesteren, Huib A. Cense, Johannes R. Anema, Annette D van Dalsen, Wouter K. G. Leclercq, Public and occupational health, APH - Societal Participation & Health, Amsterdam Reproduction & Development (AR&D), Surgery, ACS - Microcirculation, CCA - Cancer Treatment and quality of life, Obstetrics and gynaecology, ACS - Atherosclerosis & ischemic syndromes, APH - Quality of Care, and APH - Global Health
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Health Informatics ,Health Promotion ,law.invention ,Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] ,Intervention mapping ,Gynecologic Surgical Procedures ,Randomized controlled trial ,law ,Intervention (counseling) ,eHealth ,Medicine ,Humans ,intervention mapping ,hysterectomy ,Original Paper ,business.industry ,Electronic consultation ,Behavior change ,return to work ,medicine.disease ,colectomy ,Focus group ,Telemedicine ,patient reported outcome measures ,Needs assessment ,Female ,Medical emergency ,Electronics ,business ,return to normal activities - Abstract
Contains fulltext : 215610.pdf (Publisher’s version ) (Open Access) BACKGROUND: Support for guiding and monitoring postoperative recovery and resumption of activities is usually not provided to patients after discharge from the hospital. Therefore, a perioperative electronic health (eHealth) intervention ("ikherstel" intervention or "I recover" intervention) was developed to empower gynecological patients during the perioperative period. This eHealth intervention requires a need for further development for patients who will undergo various types of general surgical and gynecological procedures. OBJECTIVE: This study aimed to further develop the "ikherstel" eHealth intervention using Intervention Mapping (IM) to fit a broader patient population. METHODS: The IM protocol was used to guide further development of the "ikherstel" intervention. First, patients' needs were identified using (1) the information of a process evaluation of the earlier performed "ikherstel" study, (2) a review of the literature, (3) a survey study, and (4) focus group discussions (FGDs) among stakeholders. Next, program outcomes and change objectives were defined. Third, behavior change theories and practical tools were selected for the intervention program. Finally, an implementation and evaluation plan was developed. RESULTS: The outcome for an eHealth intervention tool for patients recovering from abdominal general surgical and gynecological procedures was redefined as "achieving earlier recovery including return to normal activities and work." The Attitude-Social Influence-Self-Efficacy model was used as a theoretical framework to transform personal and external determinants into change objectives of personal behavior. The knowledge gathered by needs assessment and using the theoretical framework in the preparatory steps of the IM protocol resulted in additional tools. A mobile app, an activity tracker, and an electronic consultation (eConsult) will be incorporated in the further developed eHealth intervention. This intervention will be evaluated in a multicenter, single-blinded randomized controlled trial with 18 departments in 11 participating hospitals in the Netherlands. CONCLUSIONS: The intervention is extended to patients undergoing general surgical procedures and for malignant indications. New intervention tools such as a mobile app, an activity tracker, and an eConsult were developed. TRIAL REGISTRATION: Netherlands Trial Registry NTR5686; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5686.
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- 2019
6. Electronic Health Program to Empower Patients in Returning to Normal Activities After Colorectal Surgical Procedures: Mixed-Methods Process Evaluation Alongside a Randomized Controlled Trial
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Charlotte de Geus, Hendrik J. Bonjer, Chantal M. den Bakker, Johannes R. Anema, Frederieke G. Schaafsma, Judith A.F. Huirne, Public and occupational health, APH - Societal Participation & Health, APH - Quality of Care, Obstetrics and gynaecology, ACS - Atherosclerosis & ischemic syndromes, Surgery, ACS - Microcirculation, CCA - Cancer Treatment and quality of life, Amsterdam Reproduction & Development (AR&D), and APH - Global Health
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,media_common.quotation_subject ,Health Informatics ,Health Promotion ,Unified theory of acceptance and use of technology ,law.invention ,Young Adult ,Randomized controlled trial ,law ,Surveys and Questionnaires ,Health care ,medicine ,eHealth ,Humans ,Medical physics ,media_common ,Aged ,Protocol (science) ,Internet ,Original Paper ,business.industry ,Convalescence ,Activity tracker ,Process Assessment, Health Care ,return to work ,Middle Aged ,colectomy ,Mobile Applications ,Colorectal surgery ,Telemedicine ,process evaluation ,patient reported outcome measures ,Female ,business ,Colorectal Neoplasms ,return to normal activities - Abstract
Background Long-term recovery takes longer than expected despite improved surgical techniques and Enhanced Recovery After Surgery programs. An electronic health (eHealth) care program ("ikherstel") was developed to partially substitute perioperative care for patients undergoing colorectal surgical procedures. Successfully tested eHealth programs are not always implemented in usual care, and it is, therefore, important to evaluate the process to optimize future implementation. Objective The aim of this study was to evaluate whether the eHealth intervention was executed as planned. Methods A mixed-methods process evaluation was carried out alongside a multicenter randomized controlled trial (RCT). This evaluation was performed using the Linnan and Steckler framework for the quantitative part of this study, measuring the components reach, dose delivered, dose received, fidelity, and participants' attitudes. Total implementation scores were calculated using the averaging approach, in which the sum of all data points is divided by the number of data points and the total adherence to the protocol is measured. For the qualitative part, the Unified Theory of Acceptance and Use of Technology framework was used. The quantitative data were based on participants' questionnaires, a logistic database, a weblog, and participants' medical files and were obtained by performing semistructured interviews with participants of the RCT. Results A total of 151 participants of 340 eligible patients were included in the RCT, of which 73 participants were allocated to the intervention group. On the basis of the quantitative process data, total implementation scores for the website, mobile app, electronic consult, and activity tracker were 64%, 63%, 44%, and 67%, respectively. Participants in the qualitative part experienced the program as supportive and provided guidance on their recovery process after colorectal surgery. Most frequently mentioned barriers were the limited interaction with and feedback from health care professionals and the lack of tailoring of the convalescence plan in case of a different course of recovery. Conclusions The intervention needs more interaction with and feedback from health care professionals and needs more tailored guidance in case of different recovery or treatment courses. To ensure a successful implementation of the program in daily practice, some adjustments are required to optimize the program in a blended care form. Trial registration Netherlands Trial Registry NTR5686; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC= 5686 (Archieved by WebCite at http://www.webcitation.org/75LrJaHrr).
- Published
- 2019
7. Using patient data to optimize an expert-based guideline on convalescence recommendations after gynecological surgery:a prospective cohort study
- Author
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Judith A.F. Huirne, Johannes R. Anema, A. Vonk Noordegraaf, Henrica C.W. de Vet, Esther V.A. Bouwsma, Obstetrics and gynaecology, APH - Quality of Care, Amsterdam Reproduction & Development (AR&D), APH - Societal Participation & Health, Public and occupational health, Epidemiology and Data Science, ACS - Atherosclerosis & ischemic syndromes, and APH - Methodology
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Adult ,medicine.medical_specialty ,Activities of daily living ,medicine.medical_treatment ,media_common.quotation_subject ,lcsh:Surgery ,Hysterectomy ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Gynecologic Surgical Procedures ,Health care ,Medicine ,Humans ,030212 general & internal medicine ,Postoperative Period ,Prospective Studies ,Prospective cohort study ,Gynecological surgery ,media_common ,Netherlands ,030219 obstetrics & reproductive medicine ,business.industry ,Convalescence ,laparoscopic adnexal surgery ,lcsh:RD1-811 ,General Medicine ,Guideline ,return to work ,Middle Aged ,Surgery ,Convalescence advice ,Practice Guidelines as Topic ,Physical therapy ,Female ,Laparoscopy ,eHealth ,business ,Abdominal surgery ,Research Article ,return to normal activities - Abstract
Background Convalescence advice is often based on tradition and anecdote from health care providers, rather than being based on experiences from patients themselves. The aim of this study was to analyse recovery in terms of resumption of various daily activities including work, following different laparoscopic and abdominal surgery in order to optimize an expert-based guideline on convalescence recommendations. Methods This is a prospective cohort study conducted in nine general and one university hospital in the Netherlands. Women aged 18–65 years and scheduled for a hysterectomy (laparoscopic, vaginal, abdominal) and/or laparoscopic adnexal surgery (n = 304) were eligible to participate. Preoperatively, participants were provided with tailored expert-based convalescence recommendations on the graded resumption of several daily activities including sitting, standing, walking, climbing stairs, bending, lifting, driving, cycling, household chores, sport activities and return to work (RTW). Postoperatively, time until the resumption of these activities was tracked. Convalescence recommendations were considered correct when at least 25% and less than 50% of the women were able to resume an activity before or at the recommended recovery time. Results There was a wide variation in the duration until the resumption of daily activities within and between groups of patients undergoing different types of surgery. Recovery times lengthened with increasing levels of physical burden as well as with increasing levels of invasiveness of the surgery. For the majority of activities actual recovery times exceeded the recovery time recommended by the expert panel. Conclusions This study provided insight in the resumption of daily activities after gynecological surgery and the adequacy of an expert-based convalescence guideline in clinical practice. Patient data was used to optimize the convalescence recommendations. Trial registration Dutch trial registry, NTR2087 (August 2009) and NTR2933 (June 2011). Electronic supplementary material The online version of this article (10.1186/s12893-017-0317-8) contains supplementary material, which is available to authorized users.
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- 2017
8. Substitution of Usual Perioperative Care by eHealth to Enhance Postoperative Recovery in Patients Undergoing General Surgical or Gynecological Procedures: Study Protocol of a Randomized Controlled Trial
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van der Meij, Eva, Huirne, Judith AF, Bouwsma, Esther VA, van Dongen, Johanna M, Terwee, Caroline B, van de Ven, Peter M, den Bakker, Chantal M, van der Meij, Suzan, van Baal, W Marchien, Leclercq, Wouter KG, Geomini, Peggy MAJ, Consten, Esther CJ, Schraffordt Koops, Steven E, van Kesteren, Paul JM, Stockmann, Hein BAC, ten Cate, A Dorien, Davids, Paul HP, Scholten, Petrus C, van den Heuvel, Baukje, Schaafsma, Frederieke G, Meijerink, Wilhelmus JHJ, Bonjer, H Jaap, Anema, Johannes R, Health Economics and Health Technology Assessment, APH - Health Behaviors & Chronic Diseases, Public and occupational health, EMGO - Quality of care, Obstetrics and gynaecology, ICaR - Ischemia and repair, Epidemiology and Data Science, and Surgery
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medicine.medical_specialty ,economic evaluation ,perioperative care ,020205 medical informatics ,Cost effectiveness ,cholecystectomy ,02 engineering and technology ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Patient satisfaction ,Quality of life (healthcare) ,Randomized controlled trial ,law ,Health care ,Protocol ,0202 electrical engineering, electronic engineering, information engineering ,medicine ,eHealth ,inguinal hernia surgery ,adnexal surgery ,030212 general & internal medicine ,cost-effectiveness ,business.industry ,convalescence ,General Medicine ,Perioperative ,Inguinal hernia surgery ,mHealth ,Physical therapy ,business ,return to normal activities - Abstract
Background: Due to the strong reduction in the length of hospital stays in the last decade, the period of in-hospital postoperative care is limited. After discharge from the hospital, guidance and monitoring on recovery and resumption of (work) activities are usually not provided. As a consequence, return to normal activities and work after surgery is hampered, leading to a lower quality of life and higher costs due to productivity loss and increased health care consumption. Objective: With this study we aim to evaluate whether an eHealth care program can improve perioperative health care in patients undergoing commonly applied abdominal surgical procedures, leading to accelerated recovery and to a reduction in costs in comparison to usual care. Methods: This is a multicenter randomized, single-blinded, controlled trial. At least 308 patients between 18 and 75 years old who are on the waiting list for a laparoscopic cholecystectomy, inguinal hernia surgery, or laparoscopic adnexal surgery for a benign indication will be included. Patients will be randomized to an intervention or control group. The intervention group will have access to an innovative, perioperative eHealth care program. This intervention program consists of a website, mobile phone app, and activity tracker. It aims to improve patient self-management and empowerment by providing guidance to patients in the weeks before and after surgery. The control group will receive usual care and will have access to a nonintervention (standard) website consisting of the digital information brochure about the surgical procedure being performed. Patients are asked to complete questionnaires at 5 moments during the first 6 months after surgery. The primary outcome measure is time to return to normal activities based on a patient-specific set of 8 activities selected from the Patient-Reported Outcomes Measurement Information System (PROMIS) physical functioning item bank version 1.2. Secondary outcomes include social participation, self-rated health, duration of return to work, physical activity, length of recovery, pain intensity, and patient satisfaction. In addition, an economic evaluation alongside this randomized controlled trial will be performed from the societal and health care perspective. All statistical analyses will be conducted according to the intention-to-treat principle. Results: The enrollment of patients started in September 2015. The follow-up period will be completed in February 2017. Data cleaning and analyses have not begun as of the time this article was submitted. Conclusions: We hypothesize that patients receiving the intervention program will resume their normal activities sooner than patients in the control group and costs will be lower. ClinicalTrial: Netherlands Trial Registry NTC4699; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4699 (Archived by WebCite at http://www.webcitation.org/6mcCBZmwy) [JMIR Res Protoc 2016;5(4):e245]
- Published
- 2016
9. Electronic Health Program to Empower Patients in Returning to Normal Activities After General Surgical and Gynecological Procedures: Intervention Mapping as a Useful Method for Further Development.
- Author
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Bakker, Chantal M den, Schaafsma, Frederieke G, van der Meij, Eva, Meijerink, Wilhelmus JHJ, van den Heuvel, Baukje, Baan, Astrid H, Davids, Paul HP, Scholten, Petrus C, van der Meij, Suzan, Baal, W Marchien van, Dalsen, Annette D van, Lips, Daniel J, Steeg, Jan Willem van der, Leclercq, Wouter KG, Geomini, Peggy MAJ, Consten, Esther CJ, Koops, Steven E Schraffordt, Castro, Steve MM de, Kesteren, Paul JM van, and Cense, Huib A
- Subjects
HEALTH programs ,ELECTRONIC health records ,GYNECOLOGY ,RANDOMIZED controlled trials ,MEDICAL consultation - Abstract
Background: Support for guiding and monitoring postoperative recovery and resumption of activities is usually not provided to patients after discharge from the hospital. Therefore, a perioperative electronic health (eHealth) intervention ("ikherstel" intervention or "I recover" intervention) was developed to empower gynecological patients during the perioperative period. This eHealth intervention requires a need for further development for patients who will undergo various types of general surgical and gynecological procedures.Objective: This study aimed to further develop the "ikherstel" eHealth intervention using Intervention Mapping (IM) to fit a broader patient population.Methods: The IM protocol was used to guide further development of the "ikherstel" intervention. First, patients' needs were identified using (1) the information of a process evaluation of the earlier performed "ikherstel" study, (2) a review of the literature, (3) a survey study, and (4) focus group discussions (FGDs) among stakeholders. Next, program outcomes and change objectives were defined. Third, behavior change theories and practical tools were selected for the intervention program. Finally, an implementation and evaluation plan was developed.Results: The outcome for an eHealth intervention tool for patients recovering from abdominal general surgical and gynecological procedures was redefined as "achieving earlier recovery including return to normal activities and work." The Attitude-Social Influence-Self-Efficacy model was used as a theoretical framework to transform personal and external determinants into change objectives of personal behavior. The knowledge gathered by needs assessment and using the theoretical framework in the preparatory steps of the IM protocol resulted in additional tools. A mobile app, an activity tracker, and an electronic consultation (eConsult) will be incorporated in the further developed eHealth intervention. This intervention will be evaluated in a multicenter, single-blinded randomized controlled trial with 18 departments in 11 participating hospitals in the Netherlands.Conclusions: The intervention is extended to patients undergoing general surgical procedures and for malignant indications. New intervention tools such as a mobile app, an activity tracker, and an eConsult were developed.Trial Registration: Netherlands Trial Registry NTR5686; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5686. [ABSTRACT FROM AUTHOR]- Published
- 2019
- Full Text
- View/download PDF
10. Electronic Health Program to Empower Patients in Returning to Normal Activities After Colorectal Surgical Procedures: Mixed-Methods Process Evaluation Alongside a Randomized Controlled Trial.
- Author
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den Bakker, Chantal M., Huirne, Judith AF, Schaafsma, Frederieke G., de Geus, Charlotte, Bonjer, Hendrik J., and Anema, Johannes R.
- Subjects
ELECTRONIC health records ,PERIOPERATIVE care ,PROCTOLOGY ,MEDICAL personnel ,CONVALESCENCE - Abstract
Background: Long-term recovery takes longer than expected despite improved surgical techniques and Enhanced Recovery After Surgery programs. An electronic health (eHealth) care program ("ikherstel") was developed to partially substitute perioperative care for patients undergoing colorectal surgical procedures. Successfully tested eHealth programs are not always implemented in usual care, and it is, therefore, important to evaluate the process to optimize future implementation.Objective: The aim of this study was to evaluate whether the eHealth intervention was executed as planned.Methods: A mixed-methods process evaluation was carried out alongside a multicenter randomized controlled trial (RCT). This evaluation was performed using the Linnan and Steckler framework for the quantitative part of this study, measuring the components reach, dose delivered, dose received, fidelity, and participants' attitudes. Total implementation scores were calculated using the averaging approach, in which the sum of all data points is divided by the number of data points and the total adherence to the protocol is measured. For the qualitative part, the Unified Theory of Acceptance and Use of Technology framework was used. The quantitative data were based on participants' questionnaires, a logistic database, a weblog, and participants' medical files and were obtained by performing semistructured interviews with participants of the RCT.Results: A total of 151 participants of 340 eligible patients were included in the RCT, of which 73 participants were allocated to the intervention group. On the basis of the quantitative process data, total implementation scores for the website, mobile app, electronic consult, and activity tracker were 64%, 63%, 44%, and 67%, respectively. Participants in the qualitative part experienced the program as supportive and provided guidance on their recovery process after colorectal surgery. Most frequently mentioned barriers were the limited interaction with and feedback from health care professionals and the lack of tailoring of the convalescence plan in case of a different course of recovery.Conclusions: The intervention needs more interaction with and feedback from health care professionals and needs more tailored guidance in case of different recovery or treatment courses. To ensure a successful implementation of the program in daily practice, some adjustments are required to optimize the program in a blended care form.Trial Registration: Netherlands Trial Registry NTR5686; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC= 5686 (Archieved by WebCite at http://www.webcitation.org/75LrJaHrr). [ABSTRACT FROM AUTHOR]- Published
- 2019
- Full Text
- View/download PDF
11. Electronic Health Program to Empower Patients in Returning to Normal Activities After General Surgical and Gynecological Procedures: Intervention Mapping as a Useful Method for Further Development.
- Author
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den Bakker CM, Schaafsma FG, van der Meij E, Meijerink WJ, van den Heuvel B, Baan AH, Davids PH, Scholten PC, van der Meij S, van Baal WM, van Dalsen AD, Lips DJ, van der Steeg JW, Leclercq WK, Geomini PM, Consten EC, Schraffordt Koops SE, de Castro SM, van Kesteren PJ, Cense HA, Stockmann HB, Ten Cate AD, Bonjer HJ, Huirne JA, and Anema JR
- Subjects
- Electronics, Female, Gynecologic Surgical Procedures methods, Humans, Gynecologic Surgical Procedures instrumentation, Health Promotion methods, Patient Reported Outcome Measures, Telemedicine methods
- Abstract
Background: Support for guiding and monitoring postoperative recovery and resumption of activities is usually not provided to patients after discharge from the hospital. Therefore, a perioperative electronic health (eHealth) intervention ("ikherstel" intervention or "I recover" intervention) was developed to empower gynecological patients during the perioperative period. This eHealth intervention requires a need for further development for patients who will undergo various types of general surgical and gynecological procedures., Objective: This study aimed to further develop the "ikherstel" eHealth intervention using Intervention Mapping (IM) to fit a broader patient population., Methods: The IM protocol was used to guide further development of the "ikherstel" intervention. First, patients' needs were identified using (1) the information of a process evaluation of the earlier performed "ikherstel" study, (2) a review of the literature, (3) a survey study, and (4) focus group discussions (FGDs) among stakeholders. Next, program outcomes and change objectives were defined. Third, behavior change theories and practical tools were selected for the intervention program. Finally, an implementation and evaluation plan was developed., Results: The outcome for an eHealth intervention tool for patients recovering from abdominal general surgical and gynecological procedures was redefined as "achieving earlier recovery including return to normal activities and work." The Attitude-Social Influence-Self-Efficacy model was used as a theoretical framework to transform personal and external determinants into change objectives of personal behavior. The knowledge gathered by needs assessment and using the theoretical framework in the preparatory steps of the IM protocol resulted in additional tools. A mobile app, an activity tracker, and an electronic consultation (eConsult) will be incorporated in the further developed eHealth intervention. This intervention will be evaluated in a multicenter, single-blinded randomized controlled trial with 18 departments in 11 participating hospitals in the Netherlands., Conclusions: The intervention is extended to patients undergoing general surgical procedures and for malignant indications. New intervention tools such as a mobile app, an activity tracker, and an eConsult were developed., Trial Registration: Netherlands Trial Registry NTR5686; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5686., (©Chantal M den Bakker, Frederieke G Schaafsma, Eva van der Meij, Wilhelmus JHJ Meijerink, Baukje van den Heuvel, Astrid H Baan, Paul HP Davids, Petrus C Scholten, Suzan van der Meij, W Marchien van Baal, Annette D van Dalsen, Daniel J Lips, Jan Willem van der Steeg, Wouter KG Leclercq, Peggy MAJ Geomini, Esther CJ Consten, Steven E Schraffordt Koops, Steve MM de Castro, Paul JM van Kesteren, Huib A Cense, Hein BAC Stockmann, A Dorien ten Cate, Hendrik J Bonjer, Judith AF Huirne, Johannes R Anema. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 06.02.2019.)
- Published
- 2019
- Full Text
- View/download PDF
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