The development of the PET@home toolkit: An experience-based co-design method study.

Objective: The relevance of pets in long-term home care is increasingly recognised because of their effects on health outcomes in clients and the rising number of clients receiving long-term care at home (further referred to as clients receiving home care). Currently, there is a lack of supportive materials that address pet-related challenges within home care. This study aimed to develop a toolkit for clients receiving home care with pets, their family, and professional caregivers using a participatory research approach. Methods: We used the Experience-Based Co-Design method involving clients receiving home care, family caregivers, and professional caregivers to create tools that are based on both theory and practice. This approach consists of four phases: 1) Exploring topics of emotional significance requiring attention (i.e., key moments) from the perspective of clients receiving home care, family caregivers, and professional caregivers; 2) Collaboratively prioritising these topics, through prioritisation meetings; 3) Developing and refining Toolkit materials through a co-design process; and 4) Evaluating the quality and feasibility of these materials. Results: Based on the results of a previously-conducted systematic review and individual interviews, we developed a preliminary information booklet and conversation cards. Subsequently, we conducted a total of 28 semi-structured interviews and seven focus groups, including one with representatives of animal interest organisations, such as veterinarians. This process led to the PET@home Toolkit which includes various materials to support pet ownership in home care settings, such as leaflets with advice on communication and animal welfare and an infographic. Conclusion: The PET@home Toolkit can support professional caregivers and their pet-owning clients receiving home care, family caregivers, and their pets. It may be a valuable addition to providing person-centred care in long-term care at home for clients with pets. The PET@home Toolkit and future updates will be readily available and free to download from May 2024 via the University Knowledge Network for Older Adult Care Nijmegen (www.ukonnetwerk.nl). Tweetable abstract: The PET@home Toolkit: Supporting pet ownership in long-term care at home.

Children's bond with companion animals and associations with psychosocial health: A systematic review.

Background: Companion animals can fulfill children's attachment needs. A secure attachment to humans is positively associated with psychosocial health, therefore, the extent to which this applies to a strong child-companion animal bond is worth examining. Aims: We aimed to gain insight into the current literature regarding the bond between children and companion animals and psychosocial health. Secondary, we also synthesized evidence about the (1) characteristics of children and companion animals and the strength of their bond; (2) the correlations between attachment to humans and the child-companion animal bond; and (3) the instruments used to measure the child-companion animal bond. Method: According to PRISMA guidelines, we searched three major electronic databases (PubMed, EBSCOhost, and Web of Science) in September 2021 and included records with the following criteria: peer reviewed English articles with quantitative and qualitative data on child-companion animal bonds and children's psychosocial health. Reports with participants younger than 18 years of age with a family owned companion animal were included. Two authors performed the screening and determined eligibility according to a predefined coding protocol. Results: The search revealed 1,025 unique records, of which we included 29 studies. Some positive associations were reported between the strength of the child-companion animal bond and children's psychosocial health outcomes like empathy, social support, and quality of life, although some results were contradictory. We found differences in associations between a child's gender, companion animal species and the strength of the child-companion animal bond. A secure attachment style to parents was positively associated with a stronger child-companion animal bond. Most of the instruments currently used, measure the strength of the bond. Discussion: This review suggests that the child-companion animal bond could be beneficial for children's psychosocial health, but some results were inconclusive. Also, not every relationship develops into an attachment. Since a strong bond with animals might not be the same as a secure attachment, we advise to modify human attachment instruments, in order to effectively study children's attachment to companion animals. Lastly, research designs that are able to investigate the causality of the relationship between the child-companion animal bond and psychosocial health are required.

[Consequences of the COVID-19 measures for wellbeing aspects of long-term care residents]. / De gevolgen van de COVID-19 maatregelen voor het welbevinden van bewoners van instellingen voor langdurige zorg.

To examine the impact of COVID-19 measures on residents of long-term care institutions, two surveys were conducted in the spring of 2020. Leontjevas et al. (study 1) inventoried practitioners' opinions, Van der Roest et al. (study 2) opinions of care workers, family, and residents without severe cognitive impairments. This article describes the combined results on social interaction and loneliness, challenging behaviour and mood, and lessons learned. In study 1, an online survey distributed to nursing home psychologists, they were asked to complete it anonymously and share the link with their fellow elderly care physicians and nurse specialists. 16 participants were then interviewed via video calling. In study 2, three hundred and fifty-seven care organizations were invited to recruit residents without severe cognitive impairments, family members and care workers for participating in a digital, anonymous survey (Study 2). The completed surveys of 323 practitioners (study 1) and 193 residents, 1609 family members and 811 employees (study 2) were included in the analyses. Social contacts of residents had changed in frequency and form compared to before the COVID-measures. Many residents experienced some loneliness during the visit ban, especially residents without cognitive impairments. There were both an increase and a decrease in challenging behaviour and affect. Several strategies used to reduce the effects of COVID-19 measures on well-being, were considered maintainable. Our studies confirmed a major impact of the COVID-19 measures on the wellbeing of long-term care residents, but also showed successful strategies of practitioners that can benefit future practice.

[Remote work and the use of online communication in nursing homes during COVID-19-measures]. / Werken op afstand en gebruik van onlinecommunicatie in verpleeghuizen tijdens COVID-19-maatregelen.

The measures taken in Dutch nursing homes during the first wave of the COVID-19 pandemic resulted in both an increase and a decrease of challenging behavior in nursing home residents. Staff undertook various initiatives to reduce the negative effects. For example, video calling between residents and their relatives was facilitated. In addition, initiatives in digital care (telehealth) were deployed. The aim of this study was to explore nursing home practitioners' experiences with online communication between residents and relatives, working remotely in general and the remote treatment of challenging behavior in particular. One hundred and seventy-five nursing home professionals (psychologists, elderly care specialists, nursing specialists, daytime activities coordinators) completed an online questionnaire at the end of 2020/start of 2021. Open and closed questions showed that face-to-face contacts are preferred over online communication. Online communication was mainly seen as a (meaningful) addition. Although professionals wanted to continue some of their work remotely, and found this efficient and workload-reducing, they felt that this could impair their job satisfaction and the quality of care. For remote work and remote treatment, each task needs to be evaluated on whether it can be performed properly and whether that results in good care. More research into online communication, remote working and digital care in nursing homes is needed.

The Relevance of Internal Working Models of Self and Others for Equine-Assisted Psychodynamic Psychotherapy.

Attachment characteristics play a key role in mental health and in understanding mental disorders. The aim of this study was to gain insight into the role the attachment characteristics can play in treatment effects in adult patients with intrapsychic and interpersonal problems who underwent Equine-assisted Short-term Psychodynamic Psychotherapy (ESTPP). In the first part of the study, we compared the effects of ESTPP to treatment-as-usual from a previous dataset regarding psychological dysfunction. For this, an explorative experimental non-randomized pre-treatment and 1-year post-treatment design was used. A mixed model revealed a significant decline in psychological dysfunction for both conditions, with no significant difference between the two. In the second part of the study, we examined the course of ESTPP effects over the period of 1 year when controlled for attachment styles and, subsequently, for internal working models of self and others. To this end, measurements were taken at baseline, 2 months waiting time, one-week intensive module, 6 months, and one year after the start of the treatment. Mixed models accounted for repeated measures showed significant improvements in psychological dysfunction, remoralization, and depression for ESTPP patients over time. The study implies that models of self and others may be used to predict the course of effects, which is relevant in determining what works for whom. In particularly, duration and intensity of therapy and a focus on the Model of Self seem relevant for shaping a more personalized treatment. ESTPP seems beneficial for patients with low pre-treatment attachment security.

[The use of guidelines for depression care in nursing homes in association with experienced competence, autonomy and relatedness by professionals]. / Toepassing van richtlijnen voor depressiezorg in verpleeghuizen en door professionals ervaren competentie, autonomie en verbondenheid.

Depression is highly prevalent in nursing homes residents and affects their quality of life. Both prevalence and impact of depression may decrease when effective guidelines or depression care programs are used, but this appears to be a challenging task. The Self Determination Theory postulates that the realization of complex tasks is being facilitated by meeting three basic human psychosocial needs: autonomy, competence and relatedness to others. This cross-sectional study investigates the relationship between the experienced autonomy, competence and relatedness and the extent to which depression care is given according to guidelines in 46 doctors, 49 psychologists and 53 nurses from 71 Dutch nursing homes. Although autonomy and competence were significantly related to depression care according to guidelines, hierarchical multiple regression analyses with all three basic needs showed a statistically significant result for competence only. The associations don't allow conclusions about causal relationships, longitudinal research will shed light on the direction of the association for competence.

Towards an assessment instrument for suffering in patients with psychiatric conditions: assessing cognitive validity.

BACKGROUND: Unbearable suffering is a key criterion in legally granting patients' euthanasia requests in Belgium yet a generally accepted definition of unbearable suffering remains elusive. The ability to understand and assess unbearable suffering is essential, particularly in patients with psychiatric conditions, as the underlying causes of these conditions are not always apparent. To enable research into when and why suffering experiences incite patients with psychiatric conditions to request euthanasia, and to help explore preventive and curative perspectives, the development of an assessment instrument is needed. AIMS: To improve the cognitive validity of a large initial item pool used to assess the nature and extent of suffering in patients with psychiatric conditions. METHOD: Cognitive validity was established via two rounds of cognitive interviews with patients with psychiatric conditions with (n = 9) and without (n = 5) euthanasia requests. RESULTS: During the first round of cognitive interviews, a variety of issues relating to content, form and language were reported and aspects that were missing were identified. During the second round, the items that had been amended were perceived as sufficiently easily to understand, sensitive to delicate nuances, comprehensive and easy to answer accurately. Neither research topic nor method were perceived as emotionally strenuous, but instead as positive, relevant, comforting and valuable. CONCLUSIONS: This research resulted in an item pool that covers the concept of suffering more adequately and comprehensively. Further research endeavours should examine potential differences in suffering experiences over time and in patients with psychiatric conditions with and without euthanasia requests. The appreciation patients demonstrated regarding their ability to speak extensively and openly about their suffering and wish to die further supports the need to allow patients to speak freely and honestly during consultations. DECLARATION OF INTERESTS: None.

Effect of 1 Year Krill Oil Supplementation on Cognitive Achievement of Dutch Adolescents: A Double-Blind Randomized Controlled Trial.

Long-chain polyunsaturated fatty acids (LCPUFA) are important for brain development and function, maybe especially during adolescence. Observational studies have demonstrated an association between fish consumption (a source of LCPUFA) and cognition in adolescents, but intervention trials are lacking. The goal of the current study was to investigate the effect of one year of krill oil (a source of LCPUFA) supplementation on the cognitive performance of adolescents with a low Omega-3 Index (O3I ≤ 5%). A double-blind, randomized, and placebo-controlled supplementation trial with repeated measurements (baseline (T0), three months (T1), six months (T2), and 12 months (T3)) in adolescents (267 randomized) was executed. Participants were randomized to 400 mg eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) per day in Cohort I or placebo and 800 mg EPA + DHA per day in Cohort II or placebo. O3I was monitored by a finger prick at all time points. At T0, T2, and T3, participants executed a neurocognitive test battery. Covariate corrected mixed models were run with either condition (krill or placebo) or O3I as predictors. Krill oil supplementation led to a small but significant increase in mean O3I, but few participants increased to the intended O3I range (8-11%). There was no significant effect of supplementation on the neurocognitive tests, nor a relationship between O3I and neurocognitive test scores. The increase in O3I was small in most participants, probably due to non-compliance. Possibly the increase in O3I was too small to demonstrate an effect. More research on the influence of LCPUFAs on cognition in adolescents is needed.

Measuring Gratitude: A Comparative Validation of the Dutch Gratitude Questionnaire (GQ6) and Short Gratitude, Resentment, and Appreciation Test (SGRAT).

The aim of this article was to validate and compare the Dutch translations of the Gratitude Questionnaire (GQ6) and the Short Gratitude, Resentment, and Appreciation Test (SGRAT) in an adult general population sample. In an online survey, 706 respondents (M age = 44, SD age = 14) completed Dutch versions of the GQ6, the SGRAT, the Satisfaction With Life Scale (SWLS) and the Positive Affect and Negative Affect Schedule (PANAS). At six week follow-up, 440 (62%) of them (M age = 46, SD age = 14) again completed the GQ6-NL and SGRAT-NL. Parallel analyses, exploratory factor analyses and confirmatory factor analyses revealed and confirmed one factor for the GQ6-NL, and three factors for the SGRAT-NL. Internal consistency indices of the GQ6-NL and of the SGRAT-NL were satisfactory. Both questionnaires demonstrated good test-retest reliability. Regression analyses showed, for the total scores on both gratitude questionnaires, positive associations with the SWLS and the Positive Affect Scale, and negative associations with the Negative Affect Scale. The results support the validity of the Dutch GQ6 and SGRAT. These questionnaires can be used to conduct further research of the grateful disposition in Dutch speaking individuals and groups.

Comprehensive assessment of depression and behavioral problems in long-term care.

BACKGROUND: The IPA Taskforce on Mental Health Issues in Long-Term Care Homes seeks to improve mental health care in long-term care (LTC) homes. The aim of this paper is to provide recommendations on comprehensive assessment of depression and behavioral problems in order to further stimulate countries and professionals to enhance their quality of care. METHODS: Existing guidelines on comprehensive assessment of depression or behavioral problems in nursing home (NH) patients or patients residing in LTC homes were collected and a literature review was carried out to search for recent evidence. RESULTS: Five guidelines from several countries all over the world and two additional papers were included in this paper as a starting point for the recommendations. Comprehensive assessment of depression in LTC homes consists of a two-step screening procedure: an investigation to identify factors that influence the symptoms, followed by a formal diagnosis of depression according to DSM-IV-TR or the Provisional Diagnostic Criteria for Depression in Alzheimer Disease in cases of dementia. Comprehensive assessment of behavioral problems encompasses three steps: description and clarification of the behavior, additional investigation, and assessment of probable causes of the behavior. The procedure starts in the case of moderate behavioral problems. CONCLUSION: The recommendations given in this paper provide a useful guide to professional workers in the LTC sector, but clinical judgment and the consideration of the unique aspects of individual residents and their situations is necessary for an optimal assessment of depression and behavioral problems. The recommendations should not be rigidly applied and implementation will differ from country to country.