Dementia is a progressive, life-limiting disease. A palliative approach to care, that focuses on the quality of life of people with dementia and their relatives, is therefore indicated. Advance... Show moreDementia is a progressive, life-limiting disease. A palliative approach to care, that focuses on the quality of life of people with dementia and their relatives, is therefore indicated. Advance care planning is core to palliative care. Relatives play a major role in this, because people with dementia often become unable to indicate their preferences for future care. Palliative dementia care is still sub optimally implemented, however. Nursing home staff and relatives of people with dementia need information about dementia and palliative care to ensure it is optimally implemented. Also, ongoing communication between everyone involved in the care of a person with dementia is required, including discussions about future care needs. This facilitates a palliative care approach in dementia. These conclusions result from a survey among elderly care physicians, a systematic review, care plan data in nursing homes and an intervention study in two nursing homes: the mySupport study. It appears that relatives want timely information about the end of life with dementia. That way they can prepare. Although physicians are usually the ones who educate relatives, nursing staff often have a stronger relationship with relatives. After training, they can play an important role in providing information. Show less
This thesis describes Saramaccan Maroon medicinal plant knowledge, practices and beliefs in relation to local health care, education and biocultural conservation. The Saramaccan ethno-medical... Show moreThis thesis describes Saramaccan Maroon medicinal plant knowledge, practices and beliefs in relation to local health care, education and biocultural conservation. The Saramaccan ethno-medical system in the village Pikin Slee focused primarily on cure followed by health promotion, and disease prevention. People made a deliberated choice for traditional medicines, even though most health concerns could be treated in the village health center. Herbal bathing plays a significant role in providing local health care among Maroons. The geographical separation between the Saramaccan and Ndyuka Maroons have led to distinct plant use in their herbal bathing practices.Writing proper Saramaccan plant names and the translation of health issues from Saramaccan into Dutch is a challenge for pupils in Pikin Slee, indicating a gap between the official school curriculum (in Dutch), traditional knowledge and literacy in Saramaccan. The growing influence of Sranantongo interrupts the conservation of Saramaccan traditional ecological and cultural knowledge stored in plant names which are influenced by European, African and Indigenous languages. Central-African Bantu languages, especially Kikongo, contributed most to the names followed by West-African Kwa languages. As Saramaccan plant names store large amounts of traditional knowledge, they play an important role in the conservation of Saramaccan biocultural heritage. Show less
As physician-scientists are able to connect research and practice, they are important to make advancements within medicine. Currently, the medical field is facing a physician-scientist shortage.... Show moreAs physician-scientists are able to connect research and practice, they are important to make advancements within medicine. Currently, the medical field is facing a physician-scientist shortage. Promoting student research engagement could be the solution. Following the need to identify how medical training could contribute to developing future physician-scientists, the general aim of this thesis was to provide insights into the impact early phases of medical training may have on cultivating physician-scientists, by elaborating on the role of motivation for research and extracurricular research programmes. By conducting quantitative and qualitative research, we showed that medical students are motivated for research at the start of medical school and that intrinsic motivation for research is related to actual research involvement. Furthermore, factors contributing to intrinsic motivation for research were identified: research self-efficacy beliefs, positive perceptions of research, curiosity, need for challenge, authentic research experiences, feelings of autonomy and relatedness, feelings of relevance or personal meaning, inspiring role models, and extracurricular research programme participation. Previous studies suggested that student research involvement is related to research involvement in professional practice. This thesis therefore emphasizes that first steps to cultivate physician-scientists could be made early on in medical school – ‘future physician-scientists: let’s catch them young!’ Show less
This thesis focused on the evaluation of an eHealth intervention for cognitive stroke rehabilitation and the perspectives of different stakeholders on the uptake of eRehabilitation in general. The... Show moreThis thesis focused on the evaluation of an eHealth intervention for cognitive stroke rehabilitation and the perspectives of different stakeholders on the uptake of eRehabilitation in general. The studies included in this thesis showed that there was no overall effect of an online brain training programme on cognitive functioning of patients with stroke. Only performances on cognitive function tests that were similar to the games included in the intervention improved, no near transfer effect was found. Moreover, usage of the training was suboptimal and not all of the patients were able to complete it. It would appear important to support stroke patients with CBCR training, since training is not well used by all patients. However, regarding patients’ ICT readiness, wishes and requirements it was also found that a relatively large amount of patients in rehabilitation wish to incorporate ICT in their rehabilitation treatment. In addition, developing tailored implementation strategies to implement eHealth in the bachelor curriculum of health professionals, based on the identified barriers and facilitators in this thesis is highly relevant to make sure that future health professionals are able to work with eHealth. Show less
