In The Netherlands about 70% of informal caregivers combine their caregiving activities with paid... more In The Netherlands about 70% of informal caregivers combine their caregiving activities with paid employment, and thus have to manage the boundaries between work and family roles. Our cross-sectional study examined whether employed informal caregivers differ from non-caring colleagues with respect to negative and positive spillover effects, health and work-related outcomes, use of formal support arrangements and experiences with a supportive work environment. Participants were recruited from a large healthcare and a financial company. Quantitative data were collected by self-administered questionnaire. Highly statistically significant, bidirectional, differences were seen with respect to work-family conflict and enrichment, but only in the health care company. In both companies health-related outcomes were scored lower among employees with family caregiving tasks. Work-related outcomes and experiences of formal and informal organizational support and hindrance were evenly distribute...
Family caregivers (FCG) play a key role in the day-to-day care of stroke survivors. Most FCG supp... more Family caregivers (FCG) play a key role in the day-to-day care of stroke survivors. Most FCG support programmes are complex public health interventions. Often, they are designed top-down without key stakeholder participation. Hence, when implementing these programmes in real world settings, they may experience “teething problems”. Optimization in practice and actively engaging its stakeholders to accurately fit the programme to the needs in practice may enhance the programmés chance of success. The Participatory Action Research (PAR) strategy was chosen for the optimization of a German primary prevention programme for stroke FCGs. Immediately after the development of the preliminary support concept (5 Conceptual Building Blocks - CBB), conducted top-down by the academic research team, iterative PAR-cycles (observe - reflect - plan - act) were applied. Together with the stakeholders (service providers and FCG), three steps were taken: (1) verifying and fitting the preliminary CBBs, (...
Action research is a qualitative research method well-known for its purpose: to bring transformat... more Action research is a qualitative research method well-known for its purpose: to bring transformative change through the simultaneous process of taking action and doing research. It typically employs a cyclical approach of observation, reflection and action. Participatory Action Research (PAR) builds on active collaboration with professionals, practitioners and end–users (stakeholders) working in the system or setting, for instance within a health care setting like a hospital, or within an broader organizational system addressing a public health issue. It seeks to democratize knowledge production and foster opportunities for empowerment by those involved. Especially in public health research, where different organizational systems or levels are interconnected, stakeholder involvement needs to be considered early in the research process. Stakeholders possess expert and insider -experiential- knowledge, and therefore power. PAR advocates for power to be shared between academic research...
International Journal of Environmental Research and Public Health, 2017
Family caregivers are the backbone of the long-term care support system within the home environme... more Family caregivers are the backbone of the long-term care support system within the home environment. Comprehensive caregiver support programs require collaboration and coordination within the system. A new public health concept, Vade Mecum, aims to harmonize and professionalize family caregiver support initiatives in geriatric care settings in the Euregion Maas-Rhine. Exploration of the new concept recently started in Germany to gain in-depth insight into current support and the needs of the geriatric care team and family caregivers. Within the context of an exploratory qualitative study, a participatory health research (PHR) strategy was applied to make optimal use of experience and knowledge from the system. Care professionals, engaged as co-researchers, were responsible for decisions about the research question, data collection methods and procedures of engaging family caregivers. A research team representing all professions within the geriatric department was formed. Research ob...
BackgroundStroke affects the entire family system. Failure to meet the needs of caregivers leads ... more BackgroundStroke affects the entire family system. Failure to meet the needs of caregivers leads to physical and mental overburdening. Stroke caregivers may benefit from professional support. The literature reviews have shown that there is still no clarity concerning the most appropriate set‐up of a support programme. In Germany, there is no stroke caregiver support programme that operates throughout the course of rehabilitation.AimThe aim was to develop a complex intervention programme for stroke caregivers in North‐Rhine Westphalia, Germany.MethodsA naturalistic enquiry approach, using a mixed‐methods design, was applied. Within one overarching qualitative study, three separate, explorative, inductive, qualitative substudies were conducted: (i) seven explorative interviews with experienced stroke caregivers, (ii) six semi‐structured interviews with professionals working within stroke rehabilitation and (iii) seventeen participant observations with focus on professional–caregiver i...
International Journal of Human Resource Studies, 2015
The number of informal caregivers who combine employment with unpaid care for an ill/disabled fam... more The number of informal caregivers who combine employment with unpaid care for an ill/disabled family acquaintance is growing. Employers are challenged to create conditions for a work-home balance for their caring employees. We identified the nature of formal leave policies and informal means of organizational support for employed carers in two Dutch companies. In 2011 we distributed a digital questionnaire among all employees in one health care and one financial company. Compared to their non-caring colleagues, in both companies the caring employees only make more use of formal leave arrangements. Neither organization offers special support measures. In both companies the caregivers value the informal support at the workplace. Organizations should offer a broad variety of formal workplace policies with customized solutions for the diverse and often unpredictable caring situations their employees are confronted with in their private lives. The formal leave system should be intensifie...
The high incidence of colon cancer in affluent societies has often been attributed to a high fat ... more The high incidence of colon cancer in affluent societies has often been attributed to a high fat diet and, more in particular, the consumption of meat. The association of the consumption of meat and the intake of fat with risk of colon cancer was investigated in a prospective cohort study on diet and cancer, which is being conducted in the Netherlands since 1986 among 120,852 men and women, aged 55-69. The analysis was based on 215 incident cases of colon cancer (105 men and 110 women) accumulated in 3.3 years of follow-up, excluding cases diagnosed in the first year of follow-up. Dietary habits were assessed at baseline with a 150-item semiquantitative food frequency questionnaire. No trends in relative rates of colon cancer were detected for intake of energy or for the energy-adjusted intake of fats, protein, fat from meat, and protein from meat. Consumption of total fresh meat, beef, pork, minced meat, chicken, and fish was not associated with risk of colon cancer either. Process...
Congres van de Vereniging voor Epidemiologie 19e WEON-congres donderdag 15 april en vrijdag 16 ap... more Congres van de Vereniging voor Epidemiologie 19e WEON-congres donderdag 15 april en vrijdag 16 april 1993 in et Academisch Centrum Amsterdam. Congres abstract.
The objective of this study was to assess which factors are related to the intention of elderly p... more The objective of this study was to assess which factors are related to the intention of elderly people to use vitamin D supplements.A questionnaire that was based on several theories, feedback of experts, and personal interviews with members of the target group was distributed among a random sample of 497 elderly people in a medium-sized town in the Netherlands (response 46%). Variables measured included perceived susceptibility, severity and control with respect to developing a vitamin D deficiency or getting a bone fracture, and beliefs, perceived social norms, modeling, self-efficacy, and intention with respect to the use of vitamin D supplements. Univariate analyses of variance, chi-square tests, stepwise multiple regression, and stepwise logistic regression analysis were performed. Respondents reporting a high intention had more positive attitudes and normative beliefs, higher self-efficacy expectations with respect to using vitamin D supplements, and more often used other supplements than respondents with a low intention. Subjects who already used vitamin D supplements were more often female and already familiar with the advice and had more positive attitudes and normative beliefs than nonusers. It was concluded that many elderly people have high intentions to start using vitamin D supplements as soon as they hear about the advice. A health promotion campaign to promote the use of vitamin D supplements should aim at making elderly people familiar with the Health Council of the Netherlands' advice. Furthermore, the campaign should place emphasis on changing attitudes, perceived social norms, and self-efficacy expectations toward vitamin D supplement use.
Family care-givers are the backbone of the long-term support system for care receivers at home. C... more Family care-givers are the backbone of the long-term support system for care receivers at home. Care for stroke survivors after rehabilitation primarily rests on the shoulders of family members, often of older age themselves. We report the outcomes of a new complex support programme, the Care-givers’ Guide, on both individual and system levels. Psycho-social support and personalised information were the main ingredients of this intervention. A two-level multi-methodological approach was needed, with two concurrent interconnected studies. Family care-givers reflected on outcomes at an individual level in a quant-QUAL study with a pre–post quantitative questionnaire and a post-intervention qualitative semi-structured interview. Practitioners participated in a QUAL-QUAL study ex post interview, reflecting on the outcomes on the care-givers and on their own stroke care system. Individual family care-givers showed an increase in health literacy and level of psycho-social health. Qualitat...
In The Netherlands about 70% of informal caregivers combine their caregiving activities with paid... more In The Netherlands about 70% of informal caregivers combine their caregiving activities with paid employment, and thus have to manage the boundaries between work and family roles. Our cross-sectional study examined whether employed informal caregivers differ from non-caring colleagues with respect to negative and positive spillover effects, health and work-related outcomes, use of formal support arrangements and experiences with a supportive work environment. Participants were recruited from a large healthcare and a financial company. Quantitative data were collected by self-administered questionnaire. Highly statistically significant, bidirectional, differences were seen with respect to work-family conflict and enrichment, but only in the health care company. In both companies health-related outcomes were scored lower among employees with family caregiving tasks. Work-related outcomes and experiences of formal and informal organizational support and hindrance were evenly distribute...
Family caregivers (FCG) play a key role in the day-to-day care of stroke survivors. Most FCG supp... more Family caregivers (FCG) play a key role in the day-to-day care of stroke survivors. Most FCG support programmes are complex public health interventions. Often, they are designed top-down without key stakeholder participation. Hence, when implementing these programmes in real world settings, they may experience “teething problems”. Optimization in practice and actively engaging its stakeholders to accurately fit the programme to the needs in practice may enhance the programmés chance of success. The Participatory Action Research (PAR) strategy was chosen for the optimization of a German primary prevention programme for stroke FCGs. Immediately after the development of the preliminary support concept (5 Conceptual Building Blocks - CBB), conducted top-down by the academic research team, iterative PAR-cycles (observe - reflect - plan - act) were applied. Together with the stakeholders (service providers and FCG), three steps were taken: (1) verifying and fitting the preliminary CBBs, (...
Action research is a qualitative research method well-known for its purpose: to bring transformat... more Action research is a qualitative research method well-known for its purpose: to bring transformative change through the simultaneous process of taking action and doing research. It typically employs a cyclical approach of observation, reflection and action. Participatory Action Research (PAR) builds on active collaboration with professionals, practitioners and end–users (stakeholders) working in the system or setting, for instance within a health care setting like a hospital, or within an broader organizational system addressing a public health issue. It seeks to democratize knowledge production and foster opportunities for empowerment by those involved. Especially in public health research, where different organizational systems or levels are interconnected, stakeholder involvement needs to be considered early in the research process. Stakeholders possess expert and insider -experiential- knowledge, and therefore power. PAR advocates for power to be shared between academic research...
International Journal of Environmental Research and Public Health, 2017
Family caregivers are the backbone of the long-term care support system within the home environme... more Family caregivers are the backbone of the long-term care support system within the home environment. Comprehensive caregiver support programs require collaboration and coordination within the system. A new public health concept, Vade Mecum, aims to harmonize and professionalize family caregiver support initiatives in geriatric care settings in the Euregion Maas-Rhine. Exploration of the new concept recently started in Germany to gain in-depth insight into current support and the needs of the geriatric care team and family caregivers. Within the context of an exploratory qualitative study, a participatory health research (PHR) strategy was applied to make optimal use of experience and knowledge from the system. Care professionals, engaged as co-researchers, were responsible for decisions about the research question, data collection methods and procedures of engaging family caregivers. A research team representing all professions within the geriatric department was formed. Research ob...
BackgroundStroke affects the entire family system. Failure to meet the needs of caregivers leads ... more BackgroundStroke affects the entire family system. Failure to meet the needs of caregivers leads to physical and mental overburdening. Stroke caregivers may benefit from professional support. The literature reviews have shown that there is still no clarity concerning the most appropriate set‐up of a support programme. In Germany, there is no stroke caregiver support programme that operates throughout the course of rehabilitation.AimThe aim was to develop a complex intervention programme for stroke caregivers in North‐Rhine Westphalia, Germany.MethodsA naturalistic enquiry approach, using a mixed‐methods design, was applied. Within one overarching qualitative study, three separate, explorative, inductive, qualitative substudies were conducted: (i) seven explorative interviews with experienced stroke caregivers, (ii) six semi‐structured interviews with professionals working within stroke rehabilitation and (iii) seventeen participant observations with focus on professional–caregiver i...
International Journal of Human Resource Studies, 2015
The number of informal caregivers who combine employment with unpaid care for an ill/disabled fam... more The number of informal caregivers who combine employment with unpaid care for an ill/disabled family acquaintance is growing. Employers are challenged to create conditions for a work-home balance for their caring employees. We identified the nature of formal leave policies and informal means of organizational support for employed carers in two Dutch companies. In 2011 we distributed a digital questionnaire among all employees in one health care and one financial company. Compared to their non-caring colleagues, in both companies the caring employees only make more use of formal leave arrangements. Neither organization offers special support measures. In both companies the caregivers value the informal support at the workplace. Organizations should offer a broad variety of formal workplace policies with customized solutions for the diverse and often unpredictable caring situations their employees are confronted with in their private lives. The formal leave system should be intensifie...
The high incidence of colon cancer in affluent societies has often been attributed to a high fat ... more The high incidence of colon cancer in affluent societies has often been attributed to a high fat diet and, more in particular, the consumption of meat. The association of the consumption of meat and the intake of fat with risk of colon cancer was investigated in a prospective cohort study on diet and cancer, which is being conducted in the Netherlands since 1986 among 120,852 men and women, aged 55-69. The analysis was based on 215 incident cases of colon cancer (105 men and 110 women) accumulated in 3.3 years of follow-up, excluding cases diagnosed in the first year of follow-up. Dietary habits were assessed at baseline with a 150-item semiquantitative food frequency questionnaire. No trends in relative rates of colon cancer were detected for intake of energy or for the energy-adjusted intake of fats, protein, fat from meat, and protein from meat. Consumption of total fresh meat, beef, pork, minced meat, chicken, and fish was not associated with risk of colon cancer either. Process...
Congres van de Vereniging voor Epidemiologie 19e WEON-congres donderdag 15 april en vrijdag 16 ap... more Congres van de Vereniging voor Epidemiologie 19e WEON-congres donderdag 15 april en vrijdag 16 april 1993 in et Academisch Centrum Amsterdam. Congres abstract.
The objective of this study was to assess which factors are related to the intention of elderly p... more The objective of this study was to assess which factors are related to the intention of elderly people to use vitamin D supplements.A questionnaire that was based on several theories, feedback of experts, and personal interviews with members of the target group was distributed among a random sample of 497 elderly people in a medium-sized town in the Netherlands (response 46%). Variables measured included perceived susceptibility, severity and control with respect to developing a vitamin D deficiency or getting a bone fracture, and beliefs, perceived social norms, modeling, self-efficacy, and intention with respect to the use of vitamin D supplements. Univariate analyses of variance, chi-square tests, stepwise multiple regression, and stepwise logistic regression analysis were performed. Respondents reporting a high intention had more positive attitudes and normative beliefs, higher self-efficacy expectations with respect to using vitamin D supplements, and more often used other supplements than respondents with a low intention. Subjects who already used vitamin D supplements were more often female and already familiar with the advice and had more positive attitudes and normative beliefs than nonusers. It was concluded that many elderly people have high intentions to start using vitamin D supplements as soon as they hear about the advice. A health promotion campaign to promote the use of vitamin D supplements should aim at making elderly people familiar with the Health Council of the Netherlands' advice. Furthermore, the campaign should place emphasis on changing attitudes, perceived social norms, and self-efficacy expectations toward vitamin D supplement use.
Family care-givers are the backbone of the long-term support system for care receivers at home. C... more Family care-givers are the backbone of the long-term support system for care receivers at home. Care for stroke survivors after rehabilitation primarily rests on the shoulders of family members, often of older age themselves. We report the outcomes of a new complex support programme, the Care-givers’ Guide, on both individual and system levels. Psycho-social support and personalised information were the main ingredients of this intervention. A two-level multi-methodological approach was needed, with two concurrent interconnected studies. Family care-givers reflected on outcomes at an individual level in a quant-QUAL study with a pre–post quantitative questionnaire and a post-intervention qualitative semi-structured interview. Practitioners participated in a QUAL-QUAL study ex post interview, reflecting on the outcomes on the care-givers and on their own stroke care system. Individual family care-givers showed an increase in health literacy and level of psycho-social health. Qualitat...
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Papers by Elisabeth Dorant