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Background: Many transition-to-practice programs have been developed to support novice nurses during their first years into practice. These programs report improvements in retention, wellbeing and clinical competence, but the driving mechanisms of these interventions remain largely unclear. Objective: To identify how transition-to-practice programs for novice nurses work and in what contexts they work successfully. Methods: A realist review was conducted. Eligibility criteria included intervention studies aimed at novice nurses in their first two years of practice that reported outcomes on organizational or individual nurse level. The underlying theory of included transition-to-practice programs was extracted, and relevant contextual factors, mechanisms and outcomes were explored and synthesized into context-mechanism-outcome (CMO) configurations. The search was limited to studies between 2000 and 2023. Results: A total of 32 studies were included, evaluating 30 different transition-to-practice programs with a wide range of intervention components including stress management, clinical education, professional and peer support, and ward rotations. Transition-to-practice programs were often designed without a theoretical foundation. Driving mechanisms behind the programs pertained to psychological, professional, and social development. Contextual factors that activated the mechanisms were enabling conditions for mentors and novice nurses, selection and motivation of novice nurses and organizational culture. Conclusions: Current transition-to-practice programs primarily focus on the individual and professional development of nurses. However, transition to practice can benefit from a systemic approach that includes development initiatives on the organizational level. Registration: PROSPERO ID CRD42021268080, August 15, 2021. Tweetable abstract: Context and mechanisms determine successful implementation of transition to practice programs for novice nurses. @transitiont

Background: The work participation of young adults with chronic physical conditions lag behind compared to healthy age-mates. ‘At Work’ is a vocational rehabilitation intervention provided by occupational therapists, that supports them for entering the competitive labour market after graduating post-secondary education. Aim: To evaluate the effects of ‘At Work’ on self-efficacy, work-ability and employment status as compared to usual care. Materials and methods: In total, 88 young adults were included in a multicentre controlled trial; 49 entered ‘At Work’, 39 received usual care. GEE-analyses were applied. Results:Scores on all outcome measures substantially improved over time in the intervention group, but no significant effects were found as compared to the control group. The effect on general self-efficacy showed a positive trend in favour of the intervention group. Conclusions and significance: Unlike previous study results pointing to positive outcomes of At Work’, the current study did not support the effectiveness of this program on work-related self-efficacy, work-ability and paid employment, as compared to usual care. Yet, we did find an indication for positive intervention effect on general self-efficacy, which is known to be an important capacity to achieve social participation.

Background: Little is known, whether physical workload and musculoskeletal complaints (MSCs) have an impact on the intended or actual dropout of nursing students in the later years of their degree program. Purpose: Studying the determinants of intention to leave and actual dropout from nursing education. We hypothesized that physical workload and MSCs are positively associated with these outcomes. Methods: A prospective cohort study among 711 third-year students at a Dutch Bachelor of Nursing degree program. Multivariable backward binary logistic regression was used to examine the association between physical work factors and MSCs, and intention to leave or actual dropout. Results: Intention to leave was 39.9% and actual dropout 3.4%. Of the nursing students, 79% had regular MSCs. The multivariable model for intention to leave showed a significant association with male sex, working at a screen, physical activity, decision latitude, co-worker support, distress and need for recovery. The multivariable model for dropout showed a significant association with living situation (not living with parents), male sex, sick leave during academic year and decision latitude. Conclusions: Our research shows that the prevalence of MSCs among nursing students is surprisingly high, but is not associated with intention to leave nor with actual dropout.

Background: Dropout in later years of the nursing degree programme involves lost investment and is a particular problem for both students and educators. Reasons for late dropout seem to be related to the work and learning environment of the clinical placement. Objectives: The aim of this study was to investigate associations between psychosocial work characteristics and distress and intention to leave nursing education among third-year nursing students. Design: A prospective cohort study. Setting: A Bachelor of Nursing programme of a University of Applied Sciences in the Netherlands. Participants: 363 third-year nursing students. Methods: Baseline and one-year follow-up measurements were used from a prospective cohort study. Third-year nursing students were invited annually in May between 2016 and 2018. Psychosocial work characteristics were psychological demands, supervisor and co-worker support, and acts of offensive behaviour. Logistic regression analyses were used to build multivariate models. Results: Frequent exposure to violence (OR = 2.52, 95% CI: 1.29–4.92) was univariately associated with distress. In the multivariate model for distress, psychological demands (OR = 1.63, 95% CI: 1.05–2.52) and frequent exposure to violence (OR = 3.02, 95% CI: 1.48–6.19) were associated with distress. Supervisor support (OR = 0.54, 95% CI: 0.36–0.80) and co-worker support (OR = 0.41, 95% CI: 0.24–0.72) were negatively associated with intention to leave (i.e. were protective) in the univariate model. In the adjusted multivariate model, only co-worker support (OR = 0.50, 95% CI: 0.25–0.97) was a protective factor for an intention to leave. Conclusion: Psychological demands and frequent exposure to violence are risk factors for distress, and co-worker support is a protective factor reducing the intention to leave nursing education in the last stage of the programme. Improving the psychosocial working climate of nursing students may reduce the intention to leave at a late st

Introduction Since the introduction of combination antiretroviral therapy, human immunodeficiency virus (HIV) infection is a manageable chronic disease. However, school-age children (4-18 years) living with HIV could still experience problems with functioning at school, due to the impact of the virus itself, medication, comorbidities and social stigma. School functioning covers academic achievement, school attendance, and social relationships and is of utmost importance to optimize normal participation. Methods To gain insight in school functioning problems of perinatally HIV-infected children, we performed a systematic review of the literature in multiple databases from January 1997 up to February 2019. Studies were included if they described outcomes of school functioning of school-age children perinatally infected with HIV, in high-income countries. Meta-analyses were performed for sufficiently comparable studies. Results and discussion Results from 32 studies show that HIV-infected children experience more problems in various areas of school functioning in comparison with national norms, matched healthy controls, siblings and HIV-exposed uninfected (HEU) children. The most pronounced differences concerned the usage of special educational services, general learning problems, and mathematics and reading performance scores. Comparisons with both national norms and siblings/HEU children show that the differences between HIV-infected children and siblings/HEU children were less pronounced. Moreover, siblings/HEU children also reported significantly worse outcomes compared to national norms. This suggests that problems in school functioning cannot be solely attributed to the HIV-infection, but that multiple socio-economic and cultural factors may play a role herein. Conclusion Perinatally HIV-infected children seem vulnerable to problems in various areas of school functioning. Therefore, monitoring of school functioning should be an important aspect in the care for

Advances in antiretroviral treatment improved the life expectancy of perinatally HIV-infected children. However, growing up with HIV provides challenges in daily functioning. This cross-sectional cohort study investigated the neuropsychological and psychosocial functioning of a group of perinatally HIV-infected children in the Netherlands and compared their outcomes with Dutch normative data and outcomes of a control group of uninfected siblings. The children’s functioning was assessed with internationally well-known and standardized questionnaires, using a multi-informant approach, including the perspectives of caregivers, teachers, and school-aged children. In addition, we explored the associations of socio-demographic and medical characteristics of the HIV-infected children with their neuropsychological and psychosocial functioning. Caregivers reported compromised functioning when compared to Dutch normative data for HIV-infected children in the areas of attention, sensory processing, social-emotional functioning, and health-related quality of life. Teachers reported in addition compromised executive functioning for HIV-infected children. A comparison with siblings revealed differences in executive functioning, problems with peers, and general health. The concurrent resemblance between HIV-infected children and siblings regarding problems in other domains implies that social and contextual factors may be of influence. A family-focused approach with special attention to the child’s socio-environmental context and additional attention for siblings is recommended.

Doel Het beschrijven van ziekteverzuim bij werkenden met een niet-traumatische klacht aan arm, nek, en/of schouder (KANS), het definiëren van ziekteverzuimtrajecten, en vaststellen van factoren die samenhangen met deze ziekteverzuimtrajecten. Opzet Prospectief cohortonderzoek. Methode Gegevens werden verzameld onder werkenden die met nieuwe KANS de huisarts consulteerden. Deelnemers vulden daarna een vragenlijst in over ziekteverzuim, persoonlijke factoren, klachtkenmerken, en algemene en werkgerelateerde fysieke en psychosociale factoren. Ziekteverzuim werd tot 2 jaar later nagevraagd met halfjaarlijkse vragenlijsten. We definieerden verschillende verzuimtrajecten met een latenteklassegroeianalyse. Om kenmerken van de verzuimtrajecten vast te stellen gebruikten we multinomiale regressieanalyse. Resultaten In totaal verzuimde 35,6% van de deelnemers (n = 533) ten minste één periode vanwege KANS. We onderscheidden 3 verzuimtrajecten: (a) een laagrisicogroep (n = 366), met een constante lage verzuimkans gedurende 2 jaar tijd; (b) een middengroep (n = 122) met een hoog risico op verzuim bij het eerste consult gevolgd door een sterke afname in het verzuimrisico; (c) een hoogrisicogroep (n = 45), met een constant hoog risico op ziekteverzuim. Vergeleken met de laagrisicogroep hadden werkenden in de andere groepen meer functionele beperkingen, minder vaak een specifieke diagnose, meer werkgerelateerde klachten, en ervoeren ze minder vaak steun van hun collega’s. Bij de deelnemers in de hoogrisicogroep kwamen vaker recidieven en comorbiditeit aan het bewegingsapparaat voor, hogere scores op somatisatie en een lagere score op taakeisen. Conclusie We hebben 3 ziekteverzuimtrajecten onderscheiden, van gunstig naar ongunstig. Verschillende klachtkenmerken, werkgerelateerde factoren en somatisatie droegen bescheiden bij aan het onderscheiden van een ongunstig beloop in ziekteverzuim tijdens het eerste consult vanwege KANS

Objective: To document the development of work participation in young adults with cerebral palsy who are transitioning into adulthood, examine associated characteristics, and investigate work limitations and barriers among employed persons.Design: Observational longitudinal cohort study.Subjects: Seventy-four young adults with cerebral palsy of average intelligence, aged 16-20 years at baseline.Methods: Work participation in 3 categories (employed, unemployed, studying) was assessed at baseline, 2-year and 4-year follow-ups using structured interviews. At 4-year follow-up, associations of work participation with demographic and clinical characteristics were examined using multinomial logistic regression. Work limitations and barriers among employed persons were evaluated using questionnaires.Results: From age range 16-20 years to age range 20-24 years the proportions of subjects who were employed and unemployed increased from 12% to 49% and 3% to 17%, respectively; the proportion who were students decreased from 85% to 34%. In the age range 20-24 years, the employment rate of young adults with cerebral palsy was lower and the unemployment rate higher, than that of the general population. A lower level of gross motor function and younger age were associated with unemployment. Employed persons experienced few work limitations; 28% experienced situational or health barriers.Conclusion: Young adults with cerebral palsy and average intelligence are at risk of experiencing unfavourable developments in work participation. Rehabilitation services should offer support to prevent unemployment and occupational disability.

Background: Complaints of arm, neck and shoulder are common in Western societies. Of those consulting a general practitioner (GP) with non-traumatic arm, neck or shoulder complaints, about 50% do not recover within 6 months. Kinesiophobia (also known as fear of movement/(re) injury) may also play a role in these complaints, as it may lead to avoidance behaviour resulting in hypervigilance to bodily sensations, followed by disability, disuse and depression. However, in relation to arm, neck and shoulder complaints little is known about kinesiophobia and its associated variables. Therefore this study aimed to: describe the degree of kinesiophobia in patients with non-traumatic complaints of arm, neck and shoulder in general practice; to determine whether mean scores of kinesiophobia change over time in non-recovered patients; and to evaluate variables associated with kinesiophobia at baseline. Methods: In this prospective cohort study set in general practice, consulters with a first or new episode of non-traumatic arm, neck or shoulder complaints (aged 18-64 years) entered the cohort. Baseline data were collected on kinesiophobia using the Tampa Scale for Kinesiophobia, the 13-item adjusted version: TSK-AV, and on patient-, complaint-, and psychosocial variables using self-administered questionnaires. The mean TSK-AV score was calculated. In non-recovered patients the follow-up TSK-AV scores at 6 and 12 months were analyzed with the general linear mixed model. Variables associated with kinesiophobia at baseline were evaluated using multivariate linear regression analyses. Results: The mean TSK-AV score at baseline was 24.8[SD: 6.2]. Among non-recovered patients the mean TSK-AV score at baseline was 26.1 [SD: 6.6], which remained unchanged over 12-months follow-up period. The strongest associations with kinesiophobia were catastrophizing, disability, and comorbidity of musculoskeletal complaints. Additionally, having a shoulder complaint, low socia