INHolland University of Applied Sciences
Haarlem, Netherlands

Inholland University of Applied science is a vocational university , located in the Netherlands. Its organizational structure is a result of a collaboration of four formally independent institutions.Inholland presents itself as ambitious, innovative, and internationally oriented. It offers Bachelor programs in the fields of Economics, Law, Management, Communication, Art , Health care, Environment studies, Education, Horticulture, Information Technology, International Business, Logistics Management, Marketing.and Aeronautical Engineering in location Delft. Wikipedia.

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Koekkoek B.,Institute for Professionalization | Koekkoek B.,Altrecht Mental Health Care | Hutschemaekers G.,Institute for Professionalization | Hutschemaekers G.,Radboud University Nijmegen | And 2 more authors.
Social Science and Medicine | Year: 2011

Across all health care settings, certain patients are perceived as 'difficult' by clinicians. This paper's aim is to understand how certain patients come to be perceived and labelled as 'difficult' patients in community mental health care, through mixed-methods research in The Netherlands between June 2006 and October 2009. A literature review, a Delphi-study among experts, a survey study among professionals, a Grounded Theory interview study among 'difficult' patients, and three case studies of 'difficult' patients were undertaken. Analysis of the results of these qualitative and quantitative studies took place within the concept of the sick role, and resulted in the construction of a tentative explanatory model. The 'difficult' patient-label is associated with professional pessimism, passive treatment and possible discharge or referral out of care. The label is given by professionals when certain patient characteristics are present and a specific causal attribution (psychological, social or moral versus neurobiological) about the patient's behaviours is made. The status of 'difficult' patient is easily reinforced by subsequent patient and professional behaviour, turning initial unusual help-seeking behaviour into 'difficult' or ineffective chronic illness behaviour, and ineffective professional behaviour. These findings illustrate that the course of mental illness, or at least the course of patients' contact with mental health professionals and services, is determined by patient and professional and reinforced by the social and mental health care system. This model adds to the broader sick role concept a micro-perspective in which attribution and learning principles are incorporated. On a practical level, it implies that professionals need to look into their own role in the perpetuation of difficult behaviours as described here. © 2010 Elsevier Ltd.

Engels G.,VU University Amsterdam | Francke A.L.,Netherlands Institute for Health Services Research NIVEL | Van Meijel B.,INHolland University of Applied Sciences | Douma J.G.,VU University Amsterdam | And 4 more authors.
Journal of Pain | Year: 2014

Studies about clinical pain in schizophrenia are rare. Conclusions on pain sensitivity in people with schizophrenia are primarily based on experimental pain studies. This review attempts to assess clinical pain, that is, everyday pain without experimental manipulation, in people with schizophrenia. PubMed, PsycINFO,, and Cochrane were searched with terms related to schizophrenia and pain. Methodological quality was assessed with the Mixed Methods Appraisal Tool. Fourteen studies were included. Persons with schizophrenia appear to have a diminished prevalence of pain, as well as a lower intensity of pain when compared to persons with other psychiatric diseases. When compared to healthy controls, both prevalence and intensity of pain appear to be diminished for persons with schizophrenia. However, it was found that this effect only applies to pain with an apparent medical cause, such as headache after lumbar puncture. For less severe situations, prevalence and intensity of pain appears to be comparable between people with schizophrenia and controls. Possible underlying mechanisms are discussed. Knowledge about pain in schizophrenia is important for adequate pain treatment in clinical practice. Perspective This review presents a valuable insight into clinical pain in people with schizophrenia. © 2014 by the American Pain Society.

Kirschner P.A.,Open University of the Netherlands | Kreijns K.,Open University of the Netherlands | Phielix C.,University Utrecht | Fransen J.,INHolland University of Applied Sciences
Journal of Computer Assisted Learning | Year: 2015

Most distributed and virtual online environments for and pedagogies of computer-supported collaborative learning (CSCL) neglect the social and social-emotional aspects underlying the group dynamics of learning and working in a CSCL group. These group dynamics often determine whether the group will develop into a well-performing team and whether a sound social space emerges. Using a theory-based CSCL framework, two studies evaluated whether two tools, Radar and Reflector, supported cognitive, social and socio-emotional aspects of team development, encouraging promotive interaction and group processing in the teams. While not affecting product quality, tool use did lead to groups who perceived their team as being better developed, as having higher levels of group satisfaction and lower levels of conflicts. The results support that promotive interaction and group processing was increased by using Radar and Reflector. © 2014 John Wiley & Sons Ltd.

Fransen J.,INHolland University of Applied Sciences | Kirschner P.A.,Open University of the Netherlands | Erkens G.,University Utrecht
Computers in Human Behavior | Year: 2011

Learning teams in higher education executing a collaborative assignment are not always effective. To remedy this, there is a need to determine and understand the variables that influence team effectiveness. This study aimed at developing a conceptual framework, based on research in various contexts on team effectiveness and specifically team and task awareness. Core aspects of the framework were tested to establish its value for future experiments on influencing team effectiveness. Results confirmed the importance of shared mental models, and to some extent mutual performance monitoring for learning teams to become effective, but also of interpersonal trust as being conditional for building adequate shared mental models. Apart from the importance of team and task awareness for team effectiveness it showed that learning teams in higher education tend to be pragmatic by focusing primarily on task aspects of performance and not team aspects. Further steps have to be taken to validate this conceptual framework on team effectiveness. © 2010 Elsevier Ltd. All rights reserved.

Wijnia J.W.,Rijnmond Care Group | Goossensen A.,INHolland University of Applied Sciences
Medical Hypotheses | Year: 2010

In literature, the cerebellum is given a substantial role in cognitive processes, in addition to traditional views on cerebellar function of regulating motor behaviour. The phenomenon of cerebellar damage causing impairments in memory and executive functioning was observed in various cerebellar disorders. Cerebellar cognitive dysfunction can be interpreted as a disturbance of cerebello-cerebral connections to areas of the cerebral cortex involved in cognitive processing, but the exact nature of the cognitive dysregulation is not known. Memory and executive dysfunction are important clinical features of Korsakoff's syndrome. We hypothesize that the Korsakoff syndrome might be an example of cerebellar neurocognitive dysfunctioning, caused by cerebello-cerebral pathways being disconnected in brain areas that are classically affected in Wernicke's encephalopathy. Further research is needed to support the possibility of cerebellar neurocognitive disturbances in Korsakoff's syndrome. If correct, this hypothesis may contribute to a better understanding of the clinical and neuropsychological profile of Korsakoff's syndrome. © 2010 Elsevier Ltd.

Van Der Voort T.Y.G.,VU University Amsterdam | Van Meijel B.,INHolland University of Applied Sciences | Goossens P.J.J.,Dimence | Hoogendoorn A.W.,GGZ InGeest | And 3 more authors.
British Journal of Psychiatry | Year: 2015

Background: A substantial number of people with bipolar disorder show a suboptimal response to treatment. Aims: To study the effectiveness of a collaborative care programme on symptoms and medication adherence in patients with bipolar disorder, compared with care as usual. Method: A two-armed, cluster randomised clinical trial was carried out in 16 out-patient mental health clinics in The Netherlands, in which 138 patients were randomised. Patient outcomes included duration and severity of symptoms and medication adherence, and were measured at baseline, 6 months and 12 months. Collaborative care comprised contracting, psychoeducation, problem-solving treatment, systematic relapse prevention and monitoring of outcomes. Mental health nurses functioned as care managers in this programme. The trial was registered with The Netherlands Trial Registry (NTR2600). Results: Collaborative care had a significant and clinically relevant effect on number of months with depressive symptoms, both at 6 months (z = 72.6, P = 0.01, d = 0.5) and at 12 months (z = 73.1, P = 0.002, d = 0.7), as well as on severity of depressive symptoms at 12 months (z = 72.9, P = 0.004, d = 0.4). There was no effect on symptoms of mania or on treatment adherence. Conclusions: When compared with treatment as usual, collaborative care substantially reduced the time participants with bipolar disorder experienced depressive symptoms. Also, depressive symptom severity decreased significantly. As persistent depressive symptoms are difficult to treat and contribute to both disability and impaired quality of life in bipolar disorder, collaborative care may be an important form of treatment for people with this disorder. © The Royal College of Psychiatrists 2015.

Freitag S.,University of Greifswald | Schmidt S.,University of Greifswald | Gobbens R.J.J.,INHolland University of Applied Sciences
Zeitschrift fur Gerontologie und Geriatrie | Year: 2016

Background: The Tilburg frailty indicator (TFI) is a self-report measurement instrument which integrates the physical, psychological and social domains to assess frailty in older adults. The aim of this study was the adaptation of the TFI to a German version and testing of the psychometric properties. Material and methods: This study surveyed 210 individuals aged 64–91 years living at home. The mean age of participants was M = 75.3±5.7 years with 62 % females. The internal consistency was tested with Cronbach’s alpha. The test-retest reliability was calculated after 20 weeks. The German TFI was validated using alternative measures for assessment of the quality of life, e.g. Eurohis-QoL-8 and short form health survey (SF-12), the patient health questionnaire (PHQ), the geriatric anxiety inventory short form (GAI-SF), the social support scale (F-Soz-U-K-14) and the resilience scale (RS-11). Results: The internal consistency was acceptable with a value for Cronbach’s alpha of 0.67. The test-retest reliability was good after 5 months α = 0.87 (physical domain r = 0.85, psychological domain r = 0.75 and social domain r = 0.84). The inter-item correlations ranged between − 0.06 and 0.57. Correlations with alternative frailty measures showed good convergent and divergent validity. Conclusion: This study showed acceptable psychometric properties of the German adaptation of the TFI which was found to be age and frailty sensitive. The results of the validity of the TFI support the three domains integrated in the frailty score. Further application and testing of the German TFI in primary care and clinical settings are suggested to consolidate the findings. © 2015, Springer-Verlag Berlin Heidelberg.

Uchmanowicz I.,Wroclaw Medical University | Wleklik M.,Wroclaw Medical University | Gobbens R.J.J.,INHolland University of Applied Sciences
Clinical Interventions in Aging | Year: 2015

Background: Chronic heart failure is a serious medical condition. Recently, there has been an increasing interest in frailty syndrome and self-care levels among patients with cardiovascular conditions. Demonstrating the influence of frailty syndrome on self-care could improve the quality of self-care and prevent the adverse effects of frailty syndrome. The purpose of this study was to assess the influence of frailty syndrome on the self-care capabilities of patients with chronic heart failure, and to identify factors associated with frailty. Methods: The data were collected between January and July 2014. The study included 110 patients with chronic heart failure who were hospitalized in the cardiology clinic. Frailty syndrome was assessed using the Tilburg Frailty Indicator, a self-report questionnaire, and self-care behavior was assessed using the European Heart Failure Self-Care Behavior Scale. Results: Fifty-four percent of the study patients were male and 46% were female. The mean age was 66±11 years, the mean Tilburg Frailty Indicator score was 7.45±3.02 points, and the mean self-care level was 27.6±7.13 points. Correlation analyses showed that patients with higher scores in the social components of the frailty scale had better self-care capabilities. Frailty was associated with age, education, duration of heart failure, number of hospitalizations, and New York Heart Association class. The effects of these patient characteristics differed across components of frailty (physical, psychological, social). Conclusion: The social components of frailty syndrome adversely affect the ability to self-care in elderly patients with heart failure. It is relevant to use a multidimensional measurement of frailty. © 2015 Uchmanowicz et al.

Uchmanowicz I.,Wroclaw Medical University | Gobbens R.J.J.,INHolland University of Applied Sciences
Clinical Interventions in Aging | Year: 2015

Objective: Elderly people constitute over 80% of the population of patients with heart failure (HF). Frailty is a distinct biological syndrome that reflects decreased physiologic reserve and resistance to stressors. Moreover, frailty can serve as an independent predictor of visits to the emergency department, hospitalizations, and mortality. The purpose of this paper was to assess the relationship between frailty, anxiety and depression, and the health-related quality of life (HRQoL) of elderly patients with HF. Patients and methods: The study included 100 patients (53 men and 47 women) with a diagnosis of HF. Frailty was measured using the Tilburg Frailty Indicator (TFI) scale. HRQoL was measured using the 36-Item Short Form Medical Outcomes Study Survey. To determine the prevalence of anxiety and depression, the Hospital Anxiety and Depression Scale was used. Results: Frailty was found in 89% of the studied population. The study showed significant inverse correlations between the values of the physical component scale (PCS) domain results and TFI score, and a significant inverse correlation between the values of the mental component scale (MCS) domain and TFI score. When participants showed increased levels of frailty as measured by the TFI scale, there was also an increase in the levels of anxiety and depression. With increased anxiety and depression, there was deterioration in the quality of life of patients with HF. Conclusion: Frailty has a negative impact on the HRQoL results of elderly patients with HF. The assessment of frailty syndrome, and anxiety and depression should be taken into account when estimating risk and making therapeutic decisions for cardiovascular disease treatment and care. © 2015 Uchmanowicz and Gobbens.

van den Hooff S.,INHolland University of Applied Sciences | Goossensen A.,University Utrecht
Scandinavian Journal of Caring Sciences | Year: 2014

Background: Involuntary admission is still raising in numbers and as a procedure a widely discussed subject from ethical point of view. A common dilemma is the tension between individual freedom and the need to protect the patient. Patients who are coerced during the admission process often report negative feelings or trauma. Finding out quality issues remains a challenge for providing good care during coercive admission. Aim: This study aims to explore themes from patients' and professionals' perspectives within scientific literature on involuntary admission. Methods: A literature review of English articles using Academic Search Elite, Cinahl, Medline, PubMed and Social Science Journals for the period 1995-2012 was conducted. Additional studies were identified using the National Centre for Biotechnology Information (NCBI). Search terms included involuntary, hospitalisation, ethical, admission, nursing home, coercion and factor. Finally, twenty-two articles were included and analysed out of 1216. Results and conclusion: Articles were divided between those describing themes from patients' perspective and articles describing themes from professionals' perspective. Findings show that most experiences of patients can be traced back to one core experience: not being listened to or listened to. When patients experience being listened to genuinely, they feel more respected as a human being. The challenge for the professional carer seems to explicitly pay attention and stay in touch with the patients' emotional struggles while making the necessarily decision to admit the patient to prevent harm. Quality of care during coercive admission improves when professionals are able to do justice to both inside and outside perspectives simultaneously. © 2013 Nordic College of Caring Science.

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