Biomedical subjects

H Philipsen

Publications and source records attributed to H Philipsen.

At least 19 recordsLinked to original sources

PubMed1999

The effects of primary nursing on work-related factors.

This study investigates the effects of a primary nursing care delivery system on some work-related factors of nurses in long-stay psychiatric care settings. In a quasi-experimental research design a cohort of 176 nurses was followed for 2.5 years. Results showed that as a result of primary nursing the primary nurses found more autonomy in their work and experienced it to be less complex. Furthermore, primary nurses performed personal care tasks less frequently and worked more according to a patient-oriented care model. Several additional analyses were performed owing to the two main problems encountered in this study, namely a high dropout due to job turnover among nurses and the imitation of the intervention by the control group.

Adult↗

PubMed1999

Multigenerational caregiving and well-being: distress of middle-aged daughters providing assistance to elderly parents.

This article investigates whether being a caregiver of an elderly parent and the caregiver's involvement in multiple roles increases distress in middle-aged women. Previous studies assumed that providing care to frail parents causes distress in women, in particular when they have other social roles as well. Longitudinal data were collected within a cohort of middle-aged women (n = 934; n = 743). The acquisition or loss of the caregiver role did not appear to affect levels of distress of middle-aged women, nor did additional roles of caregivers increase distress levels or caregiver role strain. Most distressed were women not performing any major social role, suggesting that the lack of social roles rather than the multiplicity of roles is associated with distress. The caregiver role might even reduce distress when women have very few other roles. Findings are explained in terms of the role scarcity, the role expansion and role accumulation hypotheses of role theory.

Adult↗

PubMed1999

The effect of item observability, clarity and wording on patient/nurse ratings when using the ASA scale.

Many studies show discrepancies between patients' and professionals' ratings on the same questionnaire regarding the patient's health. A relevant question is whether the differences in ratings reflect real differences between patients and professionals or whether they are caused by characteristics of the instrument. In this study, we address the latter option by examining the effects of 3 item characteristics (item wording, observability and clarity) on the degree of patient/nurse discrepancies in ratings of the items of the Appraisal of Self-care Agency (ASA) scale. Secondary analysis on 252 patient/nurse ratings showed that item wording (positively and negatively formulated items), and the observability of the items have a significant effect on the mean absolute difference score. No effect was found for clarity. These results were generally confirmed by subgroup analyses.

Humans↗

PubMed1998

Women of a middle generation and parent care.

This article addresses women who are caring for both parents and children, the so called sandwich generation or women-in-the-middle. Gerontological studies on this topic reflect controversies on the concept as well as on the size of the phenomenon. Our study attempts to demonstrate empirically to what extent middle-aged women respond to the care demands of both the generation ahead as well as the generation behind them. A population-based sample among women aged forty to fifty-four in the Netherlands (N = 933) is utilized. The study indicates the prevalence of women-in-the-middle and presents analyses of their socio-demographic characteristics as well as of patterns of parent care. Further, the potential for a cross-cultural comparison between the Netherlands and other countries is discussed regarding parent care as a normative experience and the chances of middle-aged women getting "caught" between care demands from two generations.

Adult↗

PubMed1998

Use of care by home-dwelling stroke patients during three years following hospital discharge.

Of 82 stroke survivors who had been discharged from hospital, 49 were still living at home after a three-year period. Thirty-three of these patients formed the population of the present study of the use of care at home. Sixty-one percent had received professional care and 88% had received family care. Although their overall functional status indicated only mild handicaps, after three years patients still reported a large number of disabilities and problems. The average weekly amount of family care was 37 h, and many family carers experienced a high burden of care and had emotional problems coping with the patients' disabilities. Concerning factors related to the use of care, in spite of the relatively small number of study patients, some interesting hypotheses can be advanced.

Activities of Daily Living↗

PubMed1997

Burnout and the work environment of nurses in psychiatric long-stay care settings.

The aim of this study was to investigate the relationship between burnout and a number of work-related factors among nurses working in psychiatric long-stay care settings. Another aim was to investigate the differences between these associations at individual and at group level. Differences were found in the correlations, as well as in the regression analyses, at individual and group level. The correlations between burnout and the independent variables were more often significant at individual level and the explained variances of the regression analyses were much higher at ward than at individual level. Results showed that work environments associated with low levels of burnout were those in which workers had good support and feedback, job clarity, autonomy and low levels of complexity in their work, who had managers with a social leadership style and who had realistic expectations about their patients' potential for rehabilitation. Furthermore, it was found that it was not the individual work experience of the nurse that was important in determining burnout, but the mean work experience of the nursing staff.

Adult↗

PubMed1997

Assessing the responsiveness of a functional status measure: the Sickness Impact Profile versus the SIP68.

In this study, the Sickness Impact Profile (SIP) and the SIP68 are studied for their ability to detect changes in health-related behavioral status. Methodological approaches toward responsiveness are invented and discussed. Next, literature findings on the responsiveness of the SIP are presented and judged for their validity. The SIP appeared to be able to demonstrate changes in the expected direction and in accordance with changes detected by other instruments. Using data from seven different longitudinal projects in populations with different diagnoses, the responsiveness of both the SIP136 and the SIP68 are subsequently studied and compared. In all populations, changes in functional status were indicated by both instruments. In terms of effect sizes, the SIP136 and the SIP68 do not differ significantly in their responsiveness. Moreover, changes detected by both SIPs appear to be valid representations of changes in health-related functional status.

Activities of Daily Living↗

PubMed1996

Predictors of professional and non-professional community care for care-dependent adults.

The increasing number of elderly people in most industrialized countries makes reforms in health care necessary. However, knowledge of factors that determine the use of care is scarce. The study described in this article focuses on predictors of the diversity of professional and non-professional care used by care-dependent adults who live in the community. A group of 177 care-dependent adults was identified by means of a large scale telephone survey in the Dutch community of Tegelen. Potential predictors of the diversity of professional and non-professional care were derived from Andersen's Behavioral Model of Health Services [4,5] and Litwak's Task Specifity Model [12]. Both models proved to be valuable for the explanation of variance in the diversity of care. Potential predictors derived from the two models could account for 21% of the variance for total care, 25% of the variance for professional care, and 34% of the variance for non-professional care.

Caregivers↗

PubMed1996

Coordination of care: effects on the continuity and quality of care.

Chronically ill elderly clients in three communities in the Netherlands were provided with the services of care coordinators. Two studies were performed to evaluate the effects of this intervention. A study among 38 coordinators addressed the effects on the continuity of care. A second study among 72 elderly clients addressed the effects on client satisfaction. While the study among coordinators clearly revealed effects on continuity (especially for interpersonal continuity), hardly any effects on satisfaction with care were reported by clients. Therefore, the appointment of care coordinators seems valuable when aimed at increasing continuity, but other interventions can be more appropriate for the improvement of client care.

Aged↗

PubMed1996

The effectiveness of primary nursing on burnout among psychiatric nurses in long-stay settings.

This study was set up to test the effectiveness of primary nursing on the burnout level of psychiatric nurses. It was expected that, under certain conditions, such as a primary nursing care delivery with an adequate feedback system, the burnout level would decrease. In a quasi-experimental research design, a cohort of 161 psychiatric nurses was followed for 2.5 years. Results showed that although the burnout level did not change as a result of primary nursing, psychiatric nurses and the practical nurses seemed able to work according to the principles of primary nursing. Strong indications were found that the job turnover decreased as a result of the introduction of primary nursing. Because two main problems were encountered in this study, a high drop-out due to job turnover among nurses and the imitation of the intervention by the control group, several additional analyses were performed.

Adult↗

PubMed1996

Longitudinal study on quality of life and social support in cancer patients.

The aim of the present study is to acquire insight into the changes of quality of life, social networks, and social support of cancer patients during the first year after diagnosis, as well as into the relation between social support and the changes in quality of life. Newly diagnosed cancer patients (n = 51) were followed for 1 year. Semistructured personal interviews and questionnaires were used to gather data. On the average, patients' functioning improved and the amount of physical complaints decreased over the year. Psychological complaints and the global evaluation of life, however, did not change significantly over time. The patients were supported by small, dense networks, consisting mostly of family members. Size of the networks as well as the amount of emotional support showed some decrease over time. It appeared that emotional support was positively related to quality of life. Moreover, a tendency was found to indicate that patients with a deterioration in quality of life perceived a larger decrease in emotional support than patients with a positive course. The amount of perceived instrumental support did not change significantly. There is a tendency that patients who were functioning worse had a greater need for instrumental support. Although these findings indicate relations between types of support and quality of life, we cannot make statements on the causality of these relations.

Adult↗

PubMed1996

Home care--a realistic alternative for bed-blocking stroke victims in acute hospital wards? The conceptions of caregivers in six disciplines concerned.

Up to half of the stroke patients admitted to acute hospital wards become bed-blockers. Investigations have been carried out in an effort to identify factors related to this problem. Very little is known about options which may lead to an alleviation of this problem. We investigated to what extent, in the opinions of professional representatives of six disciplines, home care can contribute to a solution. Sixty-nine stroke patients who were actually blocking beds in an acute hospital ward were described and examined on paper by a multidisciplinary panel. These patients were all moderately to severely disabled and needed a high degree of help in activities of daily life (ADL) and household activities. Estimations of the number of patients who were judged to be suitable for home care varied, although there was a fair degree of agreement between panel members concerning those patients who could and those who certainly could not return to their homes. Concerning one-third of the patients, the opinions of the caregivers diverged. Factors relating to the judgement of each panel member are identified. A method for selecting patients to be substituted to lower levels of care is suggested and discussed.

Activities of Daily Living↗

PubMed1996

[Women of the middle generation and informal care for the elderly].

In this study women are described as caregivers of both younger and older generations, the so called "sandwich generation', "women in the middle' or "middle generation'. The aim of this article was to collect data indicating the size of this phenomenon and to explore whether women in the middle provide less family care for the elderly than other caregivers. Women in the middle were defined as those women who have dependent children and give help to their parents (-in-law). In 1994 a random sample was drawn among a cohort of women aged 40-54. A telephone survey was carried out (N = 933). It appeared that almost half of the respondents (45%) gave parent care, usually 1-2 mornings/afternoons per week. A considerable proportion of the cohort (29%) were women-in-the-middle. These respondents differed in few respects from other respondents. They were relatively young and worked fewer hours per week outdoors. From this study it could not be concluded that women-in-the-middle provide less parent care than other caregivers. They appeared to spend about the same amount of time on parent care, were as often the primary caregiver of their parents(-in-law) and experienced a similar caregiver burden as often as other caregivers. However, they provided less often very intensive care.

Adolescent↗

PubMed1996

[Nurses' experiences with euthanasia in AIDS patients].

This article describes the experiences of nurses concerning the activities related to euthanasia of patients with aids. The nurses were employed in departments where relatively young, mature people wanted to arrange their own death. Our findings are based on six in-depth interviews with experienced nurses, that are part of a qualitative study into the experiences of nurses in taking leave of terminal patients with aids. The research strategy was based on the Grounded Theory. In order to analyse the experiences of the nurses, four phases were distinguished: set date and time unto application of lethal agent; application unto becoming unconscious; unconsciousness to death; death until transferring the body from the unit. Feelings that occur when taking leave of the patient, if not already taken care of at an earlier instant, play a major role in the phase from application to becoming unconscious. The fact that a deadly agent is being administered can generate feelings of guilt and anxiety. The period from unconsciousness to death is one of waiting. During this period nurses feel alienated and alone. The nurses indicated explicitly that an adequate preparation, evaluation and support are extremely important.

Acquired Immunodeficiency Syndrome↗

PubMed1995

[Patient characteristics with predictive significance for 'blocked bed' problems in the neurological department of a general hospital].

OBJECTIVE: To determine the extent and the prognostic patient characteristics of bed-blocking (hospital beds occupied by patients who no longer need specialist medical treatment) in the neurological ward of a general hospital. DESIGN: Prospective cohort study. SETTING: Maasland hospital Sittard-Geleen (location Sittard). METHOD: During one year each patient of the complete patient population of two neurological wards was registered relating to: main diagnosis, age, sex, living situation, lesion localisation (only for cerebrovascular accident (CVA) patients) and bed-blocking. The predictive patient characteristics for bed-blocking were determined by logistic regression analysis. RESULTS: 1088 patients were registered, of whom 21% with a CVA. In 10% of the registered patients bed-blocking occurred, 86% of these had the diagnosis of CVA. Of all CVA patients 40% became bed-blockers. Of all nursing days of CVA patients 20% were bed-blocking days. Among the CVA patients sex (female), age (> or = 70), and the localisation of the lesion were found to be significant risk factors for bed-blocking. The main patient characteristics predictive for bed-blocking were the diagnosis of CVA and age > or = 70 years. CONCLUSION: Neurological patients with an increased risk to end up in a blocked bed are mainly found among CVA patients. Since 20% of the nursing days of CVA patients were bed-blocking days, shortening of hospitalization time and improvement of home care is recommended.

Adult↗

PubMed1995

The tasks of psychiatric nurses in long-term residential settings in The Netherlands.

The tasks of the psychiatric nurse, working in long-term psychiatric settings, are described and analysed in this study. A questionnaire was completed by 361 nurses in five different psychiatric hospitals in the Netherlands. Nurses appear to concentrate upon personal care tasks in and around their ward. This does not fit adequately the changes in psychiatric practice. By means of an externally oriented hospital policy, cooperation with other care agencies and a realization of a more patient-orientated and rehabilitation model of care, the nurse is better prepared for helping patients make their move to the community.

Adult↗

PubMed1995

Problems of cardiac patients in early recovery.

Most studies of the problems and information needs of patients describe these only for the period of hospitalization. In this study, however, the authors focused on the first 6 months after discharge. Eighty-two cardiac patients, admitted to a university hospital with a myocardial infarction (MI) or for coronary artery bypass surgery (CABS), were interviewed 6 months after discharge. Questions required them to describe problems they experienced in early recovery and what information they needed. All but one of the 82 patients stated they had experienced problems during the first 6 months after discharge. Most problems described concerned: emotional reactions (59%), their change in physical condition (59%), deleterious effects of treatment (56%) and convalescence (54%). Topics on which most patients needed additional or different information were: deleterious effects of the treatment (26%), physical condition (24%), risk factors (24%), convalescence (24%) and knowledge of the disease (24%).

Adaptation, Psychological↗

PubMed1995

Implementing coordination of care--task performance and problems encountered.

In recent years the effects of interventions in the field of coordination of care have been well reported. However, the implementation of coordination of care is hardly addressed. This article focuses on the implementation of coordination of care for the elderly in three community settings in The Netherlands. A group of 38 professional and non-professional care-givers functioned as coordinators during a period of one year. Open interviews with coordinators, minutes from group meetings and forms and logbooks were used as sources of data. Major problems during implementation involved conflicting roles, preserving the client's privacy, lack of recognition and the perception that coordination was not always necessary. Coordinators had no difficulty in making a care inventory and in organizing care. On the other hand, introducing oneself as a coordinator, and planning and evaluating are tasks that need more attention in future interventions.

Aged↗