Background and aimsDiet is important in prevention and management of non-communicable disease and in particular, cardiovascular disease. Recently, more hospitals gear towards healthier dietary... Show moreBackground and aimsDiet is important in prevention and management of non-communicable disease and in particular, cardiovascular disease. Recently, more hospitals gear towards healthier dietary policies, however, a tool to assess the effect of these interventions in patient populations is currently lacking. The Theory of Planned Behavior (TPB) is generally used to assess health-related behavior and offers a framework for development of questionnaires. In this study, we aim to evaluate the reliability, internal consistency and preliminary construct validity of the newly developed Dietary Intention Evaluation Tool for In-hospital patients (DIETI) which is based on the TPB.Methods and resultsAn expert panel constructed the item list of the DIETI. A total of 312 patients admitted to the cardiology ward filled out the DIETI. Explanatory- and confirmatory factor analysis showed that our tool adequately discerns five TPB-consistent factors regarding a healthy diet in hospitalized patients. (N = 312, for the CFA model χ2 = 313.072 (df = 160, p < 0.001, CFI = 0.939, RMSEA = 0.058). Subsequent analysis of reliability showed satisfactory to strong internal consistency of the questionnaire as a whole and all subscales (Cronbach's alpha for the subscales ranging between 0.65 and 0.88).ConclusionsWe conclude that the DIETI is an internally reliable tool to assess behavioral intentions regarding a healthy diet of in-hospital patients. Thus, this questionnaire can be used to evaluate the effect of dietary interventions aimed at hospitalized patients. Show less
The high standard of Dutch hemophilia care and the availability of prophylaxis provide an opportunity to focus on health outcomes beyond mortality. Using both qualitative and quantitative methods,... Show moreThe high standard of Dutch hemophilia care and the availability of prophylaxis provide an opportunity to focus on health outcomes beyond mortality. Using both qualitative and quantitative methods, this thesis defined, measured and quantified relevant health outcomes for persons with hemophilia. In the first part of this thesis we showed that communication and information provision about treatment options and prophylaxis regimes may support persons with hemophilia in their decisions about current and future treatment products. This will likely result in improved bleeding outcomes. In the second part, we took the first steps towards value-based health care for hemophilia by defining a standard set of ten relevant health outcomes, including instruments to measure these outcomes. Routine measurement of the standard set may be implemented in clinical practice in order to further improve hemophilia care that adds value for patients. Already, the high standard of care has resulted in near-normal socio-economic participation of Dutch persons with hemophilia. Development of more sophisticated data collection tools will help to monitor relevant health outcomes over time. Show less
Koniewski, M.; Baranska, I.; Kijowska, V.; Steen, J.T. van der; Wichmann, A.B.; Payne, S.; ... ; PACE Project 2022
The Family Perceptions of Physician-Family Caregiver Communication scale (FPPFC) was developed to assess quality of physician-family end-of-life communication in nursing homes. However, its... Show moreThe Family Perceptions of Physician-Family Caregiver Communication scale (FPPFC) was developed to assess quality of physician-family end-of-life communication in nursing homes. However, its validity has been tested only in the USA and the Netherlands. The aim of this paper is to evaluate the FPPFC construct validity and its reliability, as well as the psychometric characteristics of the items comprising the scale. Data were collected in cross-sectional study in Belgium, Finland, Italy, the Netherlands and Poland. The factorial structure was tested in confirmatory factor analysis. Item parameters were obtained using an item response theory model. Participants were 737 relatives of nursing home residents who died up to 3 months prior to the study. In general, the FPPFC scale proved to be a unidimensional and reliable measure of the perceived quality of physician-family communication in nursing home settings in all five countries. Nevertheless, we found unsatisfactory fit to the data with a confirmatory model. An item that referred to advance care planning performed less well in Poland and Italy than in the Northern European countries. In the item analysis, we found that with no loss of reliability and with increased coherency of the item content across countries, the full 7-item version can be shortened to a 4-item version, which may be more appropriate for international studies. Therefore, we recommend use of the brief 4-item FPPFC version by nursing home managers and professionals as an evaluation tool, and by researchers for their studies as these four items confer the same meaning across countries. Show less
Valk, M.J.M. van der; Vuijk, F.A.; Putter, H.; Velde, C.J.H. van de; Beets, G.L.; Hilling, D.E. 2019
