Research Eva Goossens

Abstract

Healthcare is under increasing pressure. In this age, the health workforce shortage is rising, where nurses represent the largest professional group. Attracting and retaining healthcare workers is, therefore, of fundamental importance to ensure a viable workforce and deliver excellent quality of patient care. Research demonstrated that, especially during the early career stage, nurses proved particularly vulnerable to drop-out. This transition-to-practice is a precarious moment in the developmental trajectory of professional role identity, self-leadership behavior, and individual professional resilience. However, studies investigating the transition from nursing education to practice and factors related to early career retention are sparse. The present project aims to provide empirical research into the transition-to-practice, thereby focusing on the theoretical concepts of professional role identity, self-leadership, and professional resilience. Research on the factors that influence these important constructs is fundamental to developing a transition-to-practice program contributing to the retention of professional novice nurses.

Researcher(s)

• Promoter: Franck Erik
• Co-promoter: Goossens Eva
• Fellow: Vanuytrecht Janne

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project

Abstract

Within Western countries, the number of pregnancies and deliveries in women afflicted with acquired, congenital or inherited cardiovascular disease is significantly growing. Unfortunately, maternal heart disease is currently the leading cause of non-obstetric mortality in women during pregnancy, accounting for 33% of pregnancy-related deaths globally. To increase chances of a successful pregnancy with safeguarding maternal and fetal health on the long term, the provision of care by a multidisciplinary pregnancy heart team is recommended by several scientific and professional bodies. These European and American guidelines endorse the establishment of a joint cardio-obstetric outpatient clinic aiming to reduce the risk for adverse pregnancy outcomes. Such a Pregnancy Heart Clinic should integrate several components, including pre-conceptual counselling, perinatal risk assessment, antenatal care and post-partum follow-up. Hence, as the cohort of women of childbearing age with underlying CVD is ever growing, the evaluation of the effectiveness of a cardio-obstetric model of care is urgently needed. Although several guidelines recommend the creation of a Pregnancy Heart Clinic, these recommendations are currently largely eminence-based, urging the provision of empirical evidence as underpinning. To date, little empirical evidence is available on the patient-reported needs, organizational challenges and effectiveness of this care model in terms of feto-maternal outcomes. As maternal cardiovascular mortality and morbidity are to be considered a public health emergency, studies are needed to gain insight into successful strategies on how to create a dedicated clinic that incorporates multiple guideline-recommended components. Hence, this research project primarily aims to develop, implement and evaluate a multidisciplinary integrated care pathway for women with cardiovascular disease before, during and after pregnancy involving relevant stakeholders. To achieve this primary aim, several research objectives will be addressed in a consecutive project pathway. Three main research objectives are proposed. Firstly, we aim to gain insights into the needs, challenges and experiences of women with CVD before and after pregnancy using a qualitative study using semi-structured interviews. Secondly, we will establish a multicentric prospective registry of physiological and psychological outcomes in pregnant women with CVD during the post-partum period (i.e., fourth trimester). As part of this study, we will use a validated, standard set of parameters combining clinical outcomes, patient-reported outcomes and patient-reported experience measurements developed by ICHOM. Thirdly, we will develop an Integrated Care Pathway for women with CVD before, during and after pregnancy using the new European Pathway Association Framework. Furthermore, several scientific bodies propose to set-up a multidisciplinary cardio-obstetrics programs as a strategy to mitigate pregnancy-associated risks, limited data are currently available demonstrating the clinical and patient-reported effectiveness. Therefore, we will investigate the impact of the implementation of an integrated care pathway for women with CVD in terms of maternal, obstetric, fetal and patient-reported outcomes in the short -term post-partum period (i.e., fourth trimester).

Researcher(s)

• Promoter: Goossens Eva
• Co-promoter: Van Berendoncks An
• Fellow: Vanharen Yaël

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project

Abstract

The survival rates of children with chronic conditions have increased markedly over the past decades. Hence, many of them have a fair chance of reaching adulthood thanks to advanced treatment options. However, these patients are in need of life-long specialized care addressing their specific healthcare needs at each respective stage of their life. During adolescence, these patients are expected to transfer their care from the pediatric environment towards an adult-focused setting. To prevent an abrupt and unprepared transfer of care, it is recommended to provide these patients education, counselling and guidance through a transition program. The goal of a transition program is to prepare adolescents for the challenges faced in adulthood and adult healthcare. Although preliminary data suggest that structured transition programs are associated with increased patient satisfaction, self-care, self-advocacy, and psycho-social functioning, high quality studies on the impact of such programs are scarce. The first aim of this study is to develop a prototype of a multidisciplinary transition program for young patients with diabetes type I, asthma or obesity, using an experience-based co-design methodology. Next, the project will evaluate the impact of this program prototype in terms of clinical effectiveness, cost effectiveness and user experiences in adolescents and their families.

Researcher(s)

• Promoter: Goossens Eva
• Co-promoter: Van Hoorenbeeck Kim

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project

Abstract

In hospital, healthcare providers usually manage medication for patients although patients are expected to self-manage their medication after discharge. A lack of self-management competencies is found to be associated with low adherence levels and medication errors harming patients' health. Approximately 50% of patients afflicted by chronic conditions do not adhere to prescribed medication regimens. When self-management is allowed during hospitalization, it rarely is provided using a structured, evidence based format. Medication self-management is considered to be a promising strategy to optimize adherence rates. To date, however, empirical data demonstrating the effect of medication self-management on patient adherence is lacking. The proposed PhD project will: 1) develop and evaluate an evidence-based guideline for healthcare providers supporting patients with medication self-management problems; 2) explore medication-related shared decision making as a supportive measure in medication self-management; 3) assess the feasibility and applicability of a combined set of tools measuring medication adherence to polypharmacy from a longitudinal perspective; 4) evaluate the effect of structured medication self-management (i.e., SelfMED) on medication adherence after discharge. Using a stepped wedge trial design, the effect of the SelfMED-intervention will be compared to usual care in hospitalized patients with polypharmacy.

Researcher(s)

• Promoter: Goossens Eva
• Co-promoter: Dilles Tinne
• Fellow: Mortelmans Laura

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project