The current dissertation aims to assess the well-being of Emergency Department (ED) nurses and identify (combinations of) job factors related to this. Second, it aims to evaluate the overall... Show moreThe current dissertation aims to assess the well-being of Emergency Department (ED) nurses and identify (combinations of) job factors related to this. Second, it aims to evaluate the overall effectiveness and effective elements of an intervention implementation project conducted in multiple EDs in the Netherlands. Findings show a high prevalence of stress-related outcomes in ED nurses, but also high levels of work engagement and job satisfaction. Worktime demands and aggression/conflict situations have the strongest relationship with exhaustion, whilst work engagement is mostly related to developmental opportunities. Recovery during and outside of work can buffer the impact of patient-related stressful situations. According to a literature review, interventions can effectively prevent/reduce stress-related outcomes in nurses, with person-directed interventions reaching greater short-term effects. Little is known about their longevity and only a limited number of organization-directed studies exist. The current 2,5-year (mostly organization-directed) intervention project, led to improved working conditions but not (yet) to better well-being. Greater effects were found in hospitals with more fitting interventions and were employees felt more informed about and involved in the project. Psychosocial safety climate was positively related to communication, participation and the fit of actions to the risk factors, and as such provides a good starting point for a successful intervention project. Show less
Stroke is a relatively common condition with a large impact on patients’ lives. Rehabilitation treatment aims to support patients in coping with the physical, mental, cognitive and social... Show moreStroke is a relatively common condition with a large impact on patients’ lives. Rehabilitation treatment aims to support patients in coping with the physical, mental, cognitive and social consequences of stroke. Recently, there is an increasing interest in the application of digital technologies (eRehabilitation) in healthcare in general, including in stroke rehabilitation. ERehabilitation may include physical and cognitive exercise programs, patient information and education, e-consultations, physical activity tracking and serious gaming, preferably all together in one digital environment.Although there is evidence on the effectiveness and feasibility of eRehabilitation, the uptake of eRehabilitation in specialized stroke rehabilitation facilities has been slow, warranting the need for implementation research. The aim of this thesis was to provide insight in the complex interplay between the effectiveness, the implementation strategy and the context of eRehabilitation after stroke, as delivered in a specialized rehabilitation facility, in order to improve future use of eRehabilitation in specialized stroke rehabilitation facilities. Show less
Kleij, R.M.J.J. van der; Crone, M.R.; Paulussen, T.G.W.M.; Gaar, V.M. van de; Reis, R. 2015
The objective of the research described in this thesis was to study single and cumulative family risk in relation to early childhood externalizing problems and the effectiveness of a parenting... Show moreThe objective of the research described in this thesis was to study single and cumulative family risk in relation to early childhood externalizing problems and the effectiveness of a parenting intervention program. The Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) aimed at reducing externalizing problems in 1- to 3-year-old children by enhancing parental sensitivity and adequate discipline strategies. An evaluation of the process of this intervention was also conducted. The study consisted of a screening phase in a general population sample (N = 2408) and a randomized case-control intervention phase in a selected sub-sample of children with high levels of externalizing behaviors (n = 237). The results of this thesis showed that even at an early age, family risk predicted child externalizing behaviors. Cumulative risk longitudinally predicted externalizing behaviors, but was not related to the effectiveness of the intervention. Further, first-time parents (primiparas) profited differently from the intervention than parents with more than one child (multiparas). Finally, a positive alliance between mother and intervener predicted change in positive parenting strategies. Show less
