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Background: Community learning is one approach to promote research competencies and to involve nurses and nursing students in research. This study examines the impact of community learning according to participants—both those inside and outside the community—in a joint nursing research project at a hospital. Method: A qualitative design was selected using a participatory approach. Data were collected through semistructured interviews, reflections, conversations, and patient input during 2 academic years. Results: Thematic analysis showed 11 themes, which were organized into three clusters: realization, transformation, and influencing factors. Participants perceived changes in practice and described how their perspectives have changed on care, education, and research. Reconsiderations led to some new or revised strategies, and influencing factors were associated with the contemporary context, degree of involvement, and design/facilitation. Conclusion: The impact of community learning emerged and extended beyond community boundaries, and the indicated influencing factors must be taken into account. [ J Contin Educ Nurs. 2023;54(3):131–144.]

The sense of safety and security of older people is a widely acknowledged action domain for policy and practice in age-friendly cities. Despite an extensive body of knowledge on the matter, the theory is fragmented, and a classification is lacking. Therefore, this study investigated how older people experience the sense of safety and security in an age-friendly city. A total of four focus group sessions were organised in The Hague comprising 38 older people. Based on the outcomes of the sessions, the sense of safety and security was classified into two main domains: a sense of safety and security impacted by intentional acts and negligence (for instance, burglary and violence), and a sense of safety and security impacted by non-intentional acts (for instance, incidents, making mistakes online). Both domains manifest into three separate contexts, namely the home environment, the outdoor environment and traffic and the digital environment. In the discussions with older people on these derived domains, ideas for potential improvements and priorities were also explored, which included access to information on what older people can do themselves to improve their sense of safety and security, the enforcement of rules, and continuous efforts to develop digital skills to improve safety online. Original article at MDPI; DOI: https://doi.org/10.3390/ijerph19073960

Ondervoeding is in alle sectoren van de gezondheidszorg een veelvoorkomend probleem: gemiddeld is een op de vier a vijf patienten in ziekenhuizen, zorginstellingen en de thuiszorg ondervoed. Hoewel voedingszorg onderdeel is van essentiele verpleegkundige zorg, bestaat het bachelor-verpleegkundecurriculum anno 2019 slechts voor 0,4 procent uit voedingsonderwijs. Dat is te weinig, aldus de Stuurgroep Ondervoeding. Om te onderzoeken wat nodig is om ondervoedingsonderwijs structureel in te bedden in de Nederlandse bachelor-verpleegkundeopleidingen onderzochten wij de attitude van verpleegkundedocenten en curriculumcommissieleden ten aanzien van ondervoedingsonderwijs

In the Netherlands, there is a growing need for collective housing for older people to bridge the gap between ageing in place and institutional care facilities. The participation of older people in the concept and design stages is important to tune the market supply to the needs of (future) residents. However, social entrepreneurs find it challenging to involve older people. This chapter explores various ways older people can be involved in developing new housing initiatives. The ladder of citizen participation is used here to explore different roles that (future) residents could play with varying levels of influence, from non-participation to citizen power. Considerations for meaningful participation are discussed. Furthermore, a Dutch case study is presented, in which real estate was transformed based on the involvement of older people, which illustrates how by using an innovative method, partnerships could be formed between (future) residents and decision-makers. This chapter concludes that apart from housing itself, the built and outdoor environment should also be considered to improve the living conditions of older people.

Background: Nutritional care for older adults provided by hospital and home care nurses and nursing assistants is suboptimal. This is due to several factors including professionals' lack of knowledge and low prioritisation. Affecting these factors may promote nurses' and nursing assistants' behavioral change and eventually improve nutritional care. To increase the likelihood of successfully targeting these factors, an evidence-based educational intervention is needed. Objectives: To develop an educational intervention for hospital and home care nurses and nursing assistants to promote behaviour change by affecting factors that influence current behaviour in nutritional care for older adults. In this paper, we describe the intervention development process. Design: A multi-methods approach using literature and expert input. Settings: Hospital and home care. Participants: Older adults, nurses, nursing assistants, experts, and other professionals involved in nutritional care. Methods: The educational intervention was based on five principles: 1) interaction between intervention and users, 2) targeting users on both individual and team level, 3) supporting direct and easy transfer to the workplace, and continuous learning, 4) facilitating learning within an appropriate period, and 5) fitting with the context. Consistent with these principles, the research team focussed on developing a microlearning intervention and they established consensus on seven features of the intervention: content, provider, mode of delivery, setting, recipient, intensity, and duration. Results: The intervention consisted of 30 statements about nursing nutritional care for older adults, which nurses and nursing assistants were asked to confirm or reject, followed by corresponding explanations. These can be presented in a snack-sized way, this means one statement per day, five times a week over a period of six weeks through an online platform. Conclusions: Based on a well-founded and comprehensive procedure, the microlearning intervention was developed. This intervention has the potential to contribute to nursing nutritional care for older adults.

Systematically synthesize research about factors that influence CPD over a nursing career.Continuing professional development (CPD) in nursing is defined as 'a life-long process of active participation in learning activities that assist in developing and maintaining continuing competences, enhancing professional practice and supporting achievement of career goals'. Research has shown that inability to access resources and activities for CPD influences quality of care and adversely affects nurses' satisfaction, recruitment and retention. Although more and more research regarding CPD is done, a comprehensive overview about the needs of nurses for successful CPD is missing.Scoping review, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews ensuring all quality standards are met.Between February and April 2020 the electronic databases CINAHL, PubMed, Scopus, Psychinfo and Eric were searched as well as reference lists of included papers. Papers published in peer-reviewed journals were included without restrictions on publication date, design or setting. Thematic analysis was done to synthesize the data.The search yielded 2673 papers of which 60 papers were included. Analyses showed that factors that influence CPD differ over a nursing career, which led to the identification of three groups: newly graduated nurses; experienced nurses; and experienced nurses with ambitions for advanced roles. Furthermore, analyses showed that factors for all three groups are related to personal and contextual facilitators and barriers. Newly graduated nurses find it important to be an accepted member of the team. They experience barriers when integrating into the nursing profession, where they for instance experience workplace incivility. Experienced nurses experience contextual barriers related to a lack of supportive structures and inaccessibility of CPD resources. There is limited time and availability of role models and a lack of support from managers and other colleagues. Moreover, the clinical care dynamics influence their ability to pursue CPD. For the experienced nurses with ambitions for advanced roles, an important barrier is that nursing culture emphasizes direct patient care. Often it is unclear what the value is of new nursing roles which makes it difficult for them to develop these.All nurses strive for CPD. However, organizations need to recognize nurses' personal goals and unique strategies as this leads to different needs in CPD. In addition, resources must be made available and accessible before CPD can be successfully pursued by all nurses.

Background and objective: Hospital and home care nurses and nursing assistants do not provide optimal nutritional care to older adults, which is due to several factors that influence their current behaviour. To successfully target these factors, we developed a microlearning intervention. The next step is to assess its feasibility to achieve the best fit with nursing practice. The aim of this study was to test the feasibility of the microlearning intervention about nutritional care for older adults provided by hospital and home care nurses and nursing assistants.Methods: In a multicentre study, we used a mixed-methods design. Feasibility was determined by assessing 1) recruitment and retention of the participants and 2) the acceptability, compliance and delivery of the intervention. Data about the use of the intervention (consisting of 30 statements), and data from a standardised questionnaire and two focus group interviews were used to measure the feasibility outcomes.Results: Fourteen teams with a total of 306 participants (response rate: 89.7%) completed the intervention and the median (Q1, Q3) score for completed statements per participant was 23 (12, 28). The mean proportion of correct answers was 72.2%. Participants were both positive and constructive about the intervention. They confirmed that they mostly learned from the intervention. Overall, the intervention was acceptable to the participants and compliance and delivery was adequate.Conclusions: The microlearning intervention is mostly feasible for hospital and home care nurses and nursing assistants. Based on participants’ constructive feedback, we consider that the intervention needs refinement to improve its feasibility.

The World Health Organization (WHO) strives to assist and inspire cities to become more ‘age-friendly’ through the Global Age-Friendly Cities Guide. An age-friendly city offers a supportive environment that enables residents to grow older actively within their families, neighbourhoods and civil society, and offers extensive opportunities for their participation in the community. In the attempts to make cities age-friendly, ageism may interact with these developments. The goal of this study was to investigate the extent to which features of age-friendly cities, both facilitators and hindrances, are visible in the city scape of the Dutch municipalities of The Hague and Zoetermeer and whether or not ageism is manifested explicitly or implicitly. A qualitative photoproduction study based on the Checklist of Essential Features of Age-Friendly Cities was conducted in five neighbourhoods. Both municipalities have a large number of visual age-friendly features, which are manifested in five domains of the WHO model, namely Communication and information; Housing; Transportation; Community support and health services; and Outdoor spaces and buildings. Age-stereotypes, both positive and negative, can be observed in the domain of Communication and information, especially in the depiction of third agers as winners. At the same time, older people and age-friendly features are very visible in the cityscapes of both municipalities, and this is a positive expression of the changing demographics. Original article at Sage: https://doi.org/10.1177/1420326X19857216

In the Netherlands, there is a growing need for collective housing for older people to bridge the gap between ageing-in-place and institutional care facilities. Participation of older people in the concept and design phases is important to tune the market supply to the needs of (future) residents, yet social entrepreneurs find it challenging to involve older people. This commentary explores various ways older people can participate in the development of new housing initiatives. The ladder of citizen participation is applied to explore different roles that (future) residents could play with levels of influence varying from non-participation to citizen power. Considerations for meaningful participation are discussed, in order to show how collaborations can be formed between (future) residents and decision makers. Original article at: https://doi.org/10.3390/healthcare9030301 © 2021 by the authors. Licensee MDPI.

Introduction Coastal locations contribute significantly to global drowning, with surfers frequently conducting rescues. This study explored the characteristics of surfers as bystander rescuers in Europe. Methods A cross-sectional online survey collected demographics (age, sex, geographical location), surfing experience, ability, lifesaving and cardiopulmonary resuscitation (CPR) training, information seeking behaviors and previous performance of a rescue. Analyses comprised descriptive frequencies, binomial logistic regression with adjusted odds ratio (AOR) (95% confidence interval [CI]) and chi-squares (p < .05). Results Europe-dwelling respondents totaled 1705 (76% male; 43% 25–34 years). Thirty-nine percent (39.2%; n = 668) had previously performed a rescue. Likelihood of having conducted a rescue significantly increased with 6 or more years of surfing experience (6–10 years [AOR = 1.96; 95%CI: 1.20–3.22]; 11–15 years [AOR = 3.26; 95%CI: 1.56–6.79]; 16 years or more [AOR = 4.27; 95%CI: 2.00–9.11]) when compared to surfers with

Background Due to multimorbidity and geriatric problems, older people often require both psychosocial and medical care. Collaboration between medical and social professionals is a prerequisite to deliver high-quality care for community-living older people. Effective, safe, and person-centered care relies on skilled interprofessional collaboration and practice. Little is known about interprofessional education to increase interprofessional collaboration in practice (IPCP) in the context of community care for older people. This study examines the feasibility of the implementation of an IPCP program in three community districts and determines its potential to increase interprofessional collaboration between primary healthcare professionals caring for older people. Method A feasibility study was conducted to determine the acceptability and feasibility of data collection and analysis regarding interprofessional collaboration in network development. A questionnaire was used to measure the learning experience and the acquisition of knowledge and skills regarding the program. Network development was assessed by distributing a social network survey among professionals attending the program as well as professionals not attending the program at baseline and 5.5 months after. Network development was determined by calculating the number, reciprocity, value, and diversity of contacts between professionals using social network analysis. Results The IPCP program was found to be instructive and the knowledge and skills gained were applicable in practice. Social network analysis was feasible to conduct and revealed a spill-over effect regarding network development. Program participants, as well as non-program participants, had larger, more reciprocal, and more diverse interprofessional networks than they did before the program. Conclusions This study showed the feasibility of implementing an IPCP program in terms of acceptability, feasibility of data collection, and social network analysis to measure network development, and indicated potential to increase interprofessional collaboration between primary healthcare professionals. Both program participants and non-program participants developed a larger, more collaborative, and diverse interprofessional network.

ObjectivesMost complex healthcare interventions target a network of healthcare professionals. Social network analysis (SNA) is a powerful technique to study how social relationships within a network are established and evolve. We identified in which phases of complex healthcare intervention research SNA is used and the value of SNA for developing and evaluating complex healthcare interventions.MethodsA scoping review was conducted using the Arksey and O’Malley methodological framework. We included complex healthcare intervention studies using SNA to identify the study characteristics, level of complexity of the healthcare interventions, reported strengths and limitations, and reported implications of SNA. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews 2018 was used to guide the reporting.ResultsAmong 2466 identified studies, 40 studies were selected for analysis. At first, the results showed that SNA seems underused in evaluating complex intervention research. Second, SNA was not used in the development phase of the included studies. Third, the reported implications in the evaluation and implementation phase reflect the value of SNA in addressing the implementation and population complexity. Fourth, pathway complexity and contextual complexity of the included interventions were unclear or unable to access. Fifth, the use of a mixed methods approach was reported as a strength, as the combination and integration of a quantitative and qualitative method clearly establishes the results.ConclusionSNA is a widely applicable method that can be used in different phases of complex intervention research. SNA can be of value to disentangle and address the level of complexity of complex healthcare interventions. Furthermore, the routine use of SNA within a mixed method approach could yield actionable insights that would be useful in the transactional context of complex interventions.

Background: Interprofessional collaboration in practice (IPCP) between professionals from the medical and social domain within primary care is desirable; however, it is also challenging due to fragmented healthcare. Little is known about the development of IPCP in primary care to fit the implementation context. This article describes the methodological development and the final content of an IPCP program.Methods and findings: The development process started with the identification of IPCP competencies in a literature review and a qualitative needs analysis with semi-structured interviews among eight elders and four health care professionals. The results were discussed during a first consultation with an expert team, which consisted of ten health care professionals. Consensus was reached on the themes role identity, communication, and shared vision development to form the basis of the program. A second consultation with the experts discussed the first version of the program. Then, consensus was reached on the final version of the program, which included a blended learning approach consisting of two face-to-face meetings, online learning, and on-the-job learning with a sixteen-hour time investment over a six-week period.Conclusions: The IPCP program was developed based on educational strategies and evidence, and with the support and knowledge of practice experts to fit the implementation context.

Vergrijzing, nieuw opnamebeleid: verpleegkundigen in de ziekenhuizen zien steeds vaker oudere patienten met complexe zorgproblematiek. Het leren over de zorg aan deze patienten houdt niet op bij de schoolbanken: verpleegkundigen moeten die kennis bijhouden en blijven ontwikkelen in de loop van hun carriere. Hoe is het gesteld met het kennisniveau van verpleegkundigen over de oudere patient? Een onderzoek onder mbo- en hbo-verpleegkundigen, van studenten en net-afgestudeerden tot verpleegkundigen met jarenlange ervaring in de ziekenhuispraktijk.

Effective, safe, person-centred care relies on skilled interprofessional collaboration (IPC) and practice. Little is known about interprofessional education (IPE) to increase IPC in the context of care for frail older people in the community. This study evaluates the effectiveness of IPE on IPC of primary health and social care providers providing care to frail older people in three districts in the Netherlands. A before-after study among 55 health care professionals using social network analysis was performed. The number of contacts increased on average with two contacts. The reciprocity in the districts increased with 15%, 2% and 13%. The diversity of contacts increased between 6% and 10% (p

Nurses play an important role in the prevention and treatment of malnutrition in older adults. However, research shows that nurses lack the motivation to give adequate nutritional care. In order to change this motivation a learning intervention about nutrition in older adults targeted at nurses would be desirable. The aim of this study was to assess the development, validation, and reliability of a learning intervention about nutrition in older adults. The results show that this learning intervention has a good construct and content validity, and is psychometrically sound. Questions of the learning intervention can be presented at once or in a snack-sized way, where the questions are presented over a period of time. This learning intervention can be used for developers of similar interventions, and as part of educating programs for nursing professionals and nursing students about nutritional care for older adults.

Aims and objectives: The aim of this study is to validate the “Older Patients in Acute Care Survey” (OPACS) in the Netherlands. Background: Worldwide the population of older people with multimorbidity increases which results in an increase of older hospitalized patients. Literature shows that nurses have a negative attitude towards older patients. To get insight and improve the attitude of nurses, a validated measurement instrument is needed. The OPACS measures hospital nurses' attitudes towards older patients and has proven good content validity in the USA and good face validity and reliability in Australia. Design: A cross-sectional study. Methods: First the OPACS was translated using forward-backward method and testing clarity of wording with a pilot. Second content validity was determined using “Method Lynn” and clarity of wording and appropriateness for measuring attitude were identified. Results: The OPACS showed acceptable content validity (CVI ≥ 0.78) for 14 items (out of 36) of Section A and 22 items (out of 50) of Section B. The content validity for the entire OPACS was (CVI = 0.62). 89.2% of the participants scored “clear in wording” and 75.6% of the participants qualified the OPACS appropriate for measuring attitude. Conclusions: The OPACS has good clarity of wording and good appropriateness for measuring attitude. The content validity is low which makes the current Dutch version not appropriate for measuring attitude of nurses in Dutch hospitals. Relevance to clinical practice: A measurement instrument to get insight in the attitude of nurses is a first step to improve a negative attitude. A positive attitude of nurses is important to provide good quality of care to the increasing population older people in hospitals. Working with reliable and validated scales is important. This study gives direction to make the OPACS suitable for the Dutch situation.

Background: Although there is a growing population of older adults admitted to hospitals, the literature demonstrates knowledge deficits of nurses regarding older patients. This study investigated knowledge levels of both nursing students and RNs about older hospitalized patients in relation to their educational level and work experience. Method: First- and final-year vocational and bachelor nursing students, and associate degree and bachelor degree nurses working in the hospital setting with 0 to 5 years, 6 to 15 years, and more than 15 years of experience, have completed the Knowledge about Older Patients–Quiz (KOP-Q). The KOP-Q has a clearly described theoretical base finding its origin in knowledge regarding nursing care for older patients and shows good content and construct validity. Results: A substantial proportion of participants in all groups demonstrated insufficient knowledge about older patients. A difference in knowledge exists among nurses with different educational qualifications, and a link between years of experience and higher knowledge levels of nurses is found. Conclusion: Throughout the nursing career, basic care topics in relation to care for older patients should play a key role in basic nursing education programs, as well as for continuing education programs provided in hospitals for nurses. J Contin Educ Nurs. 2018;49(2):84–90.

Background: In clinical practice, nurses’ attitudes regarding older patients are important in relation to quality of care. The Older People in Acute Care Survey (OPACS) is an instrument measuring hospital nurses attitudes regarding older patients and is validated in Australia and the USA. The OPACS is translated in Dutch language and content validity of this translation is previously assessed, presenting questionable results. Measurement instruments, however, cannot be “validated” based on content validity evidence alone. Judgmental evidence and statistical analysis should be combined to fully evaluate content domain definition and representation and guide further development. Objective: Assess structural validity and reliability to fully evaluate the OPACS for use in the Netherlands, complementing previous conducted content validity results. Design: Cross-sectional. Setting: Three general hospitals in the Netherlands. Participants: 201 registered nurses. Methods: Confirmatory factor analysis was used to assess the structural validity. Reliability was assessed with Cronbach’s alpha. Results: OPACS Section A (measuring practice experiences) demonstrated to have acceptable structural validity- and good reliability outcomes after exclusion of two items (model fit: x² [df=537]=8475.40, p |z|)= 0.551 -0 .788). Conclusion: Even though structural validity for section A was acceptable, content validity scores of a majority of items in this subscale were low, resulting in questionable use of this subscale for the Dutch context. The findings of this study, in relation to the earlier findings regarding content validity, justify the conclusion that use of the Dutch OPACS in clinical practice and research is not recommended. Given these findings, future research should pursue the development or (cross-cultural) validation of other instruments measuring hospital nurses attitudes towards older patients for the Dutch cultural context. Furthermore, this study demonstrated the influence of cultural differences on measurement instruments and the need for rigorous research before using a measurement instrument in a new culture or context.

Background The Knowledge about Older Patients-Quiz (KOP-Q) is designed as a unidimensional scale measuring knowledge of hospital nurses about older patients. Furthermore, the KOP-Q measures a second unidimensional construct, certainty of hospital nurses about their knowledge. The KOP-Q is developed and validated in the Netherlands. Whether the KOP-Q can be used in other countries is unknown given the cultural and language differences. Objectives Investigate the level of measurement invariance of the KOP-Q between the Netherlands and United States of America (USA). Design A multicenter international cross-sectional design. Settings Four general hospitals in the Netherlands and four general hospitals in the USA. Participants Nurses from the Netherlands (n = 201) and the USA (n = 130) were invited to participate by email from the ward manager, distributing flyers and present messages on the online hospital communication boards. Questions of the KOP-Q were completed online. Method The level of measurement invariance (configural, metric or scalar invariance) across countries was tested by running increasingly constrained structural equation models, and testing whether these models fitted the data. Results Both the knowledge and certainty construct of the KOP-Q proved unidimensional in the Netherlands and USA sample. Test results of the measurement invariance across the Netherlands and USA indicated a stable, partial scalar invariance (15 items full scalar invariance) for the knowledge items and full scalar invariance for the certainty items. Conclusions The KOP-Q shows to function uniformly across both language groups and can therefore be used to assess nurses' knowledge and their certainty about this knowledge which can be important for educational and/or quality improvement programs in the USA. Furthermore, the KOP-Q is suitable to make comparisons between the Netherlands and the USA using latent variable models. Before the KOP-Q can be used in other countries, cross-cultural tests should again be performed.

Objectives To assess the content validity and psychometric characteristics of the Knowledge about Older Patients Quiz (KOP-Q), which measures nurses' knowledge regarding older hospitalized adults and their certainty regarding this knowledge. Design Cross-sectional. Setting Content validity: general hospitals. Psychometric characteristics: nursing school and general hospitals in the Netherlands. Participants Content validity: 12 nurse specialists in geriatrics. Psychometric characteristics: 107 first-year and 78 final-year bachelor of nursing students, 148 registered nurses, and 20 nurse specialists in geriatrics. Measurements Content validity: The nurse specialists rated each item of the initial KOP-Q (52 items) on relevance. Ratings were used to calculate Item-Content Validity Index and average Scale-Content Validity Index (S-CVI/ave) scores. Items with insufficient content validity were removed. Psychometric characteristics: Ratings of students, nurses, and nurse specialists were used to test for different item functioning (DIF) and unidimensionality before item characteristics (discrimination and difficulty) were examined using Item Response Theory. Finally, norm references were calculated and nomological validity was assessed. Results Content validity: Forty-three items remained after assessing content validity (S-CVI/ave = 0.90). Psychometric characteristics: Of the 43 items, two demonstrating ceiling effects and 11 distorting ability estimates (DIF) were subsequently excluded. Item characteristics were assessed for the remaining 30 items, all of which demonstrated good discrimination and difficulty parameters. Knowledge was positively correlated with certainty about this knowledge. Conclusion The final 30-item KOP-Q is a valid, psychometrically sound, comprehensive instrument that can be used to assess the knowledge of nursing students, hospital nurses, and nurse specialists in geriatrics regarding older hospitalized adults. It can identify knowledge and certainty deficits for research purposes or serve as a tool in educational or quality improvement programs.

An introduction: Care for older people with multiple chronic conditions and complex care require different disciplines which are often simultaneously involved. Interprofessional collaboration between professionals from medical and social care in the community is necessary to enhance quality of life and support of older people. Short description of practice change implemented: An interprofessional training IPT for professionals working with older people in primary care was developed and pilot tested. Three central themes for the training were defined: collaboration, role identity and communication. Aim and theory of change: The aim of the IPT is to enhance collaboration and communication between multiple professionals in primary care so that they are adequately equipped to provide integrated care for older people. Professionals learn from and with each other how collaboration in primary care can be improved and what they need from each other. The IPT consisted of two teaching days within the community and multiple online and onsite assignments e.g. blended learning. Targeted population and stakeholders: To enhance the fit between the needs and wishes of the professionals and the goals of the IPT, an expert team consisting of multiple stakeholders were involved e.g. general practitioner, practical nurses, specialized nurses, and social work. The expert team was consulted about the content and form of the training several times to ensure co-creation. In total, twenty-three primary care professionals e.g. community nurses, general practitioners, nurse practitioners, pharmacists, social workers, and welfare professionals were trained in three communities. Timeline: The training duration was six weeks. Highlights innovation, Impact and outcomes: The IPT is evaluated on three interprofessional outcomes defined by Reeves 20161. The first and second outcome evaluates reaction, knowledge- and skills. These two outcomes were positively evaluated during the pilot. Third, behavioral change in the collaboration between the professionals was measured with Social Network Analysis to explore what changes took place in terms of size and strength of the collaboration. Sustainability: The IPT will be sustained by a non-profit organization that offers training on collaborative practice at community level. Furthermore, elements of the training will be embedded in the bachelor nursing education at the University of Applied Sciences Utrecht. Transferability: The content of the training can be integrated in bachelor nursing education and the outline of the training has an excellent fit with clinical practice due to the blended character. Conclusions: The IPT is experienced as positive by all community teams. The results regarding the size and strength of the collaboration between the professionals i.e. evaluation of behavioral change, will be expected begin 2018. Discussion: Little is known about IPT in the context of home and community care of older adults2. Therefore, this IPT serves as an example in developing and evaluating an IPT in primary care settings. Lessons learned: Co-creation appears to be essential in the development of IPT because equivalent influence of all involved stakeholders including the target population can guaranteed an optimal fit for primary care practice.

Summary Background Literature shows that nurses have a negative attitude toward older patients. Increasing nurses' knowledge (part of attitudes) may affect hospital nurses' attitudes and improve the quality of care for older patients. A first step is understanding nurses' current knowledge. This can be achieved by using a measurement instrument with good validity and reliability. Objectives This study explains the content development and initial validation of the 'Knowledge about Older Patients Quiz' (KOP-Q) for nurses, describing the first step in developing a valid and reliable instrument. Design Qualitative method followed by 2 pilot studies. Methods Open interviews were conducted with 7 scientific experts and 10 nurse specialists in gerontology, geriatrics, and/or nursing and 5 older patients, 70 + with hospital experience in the last two years. The data were analyzed using thematic analysis. Items were generated from literature on themes derived from interviews. A Delphi round with three nurse specialists and two researchers was organized for item reduction. Two pilot survey studies were conducted for measuring readability and face validity of the KOP-Q. Readability was examined by a Dutch language specialist and 7 nurses working on a cardiovascular ward. Face validity was tested in two hospitals with 22 nurses working on geriatric wards. Results Identified themes were: normal aging, geriatric conditions, signaling problems in old age, interventions, family interventions, vulnerable patients versus older patients and internal motivation for learning and reflection. 185 questions on these themes were developed. After conceptualization, generation and reduction of questions in the Delphi round 52 questions remained eligible for use. Readability and face validity of this initial version of the KOP-Q proved good. Conclusions Content development of the KOP-Q is of good methodological rigor and each step is carefully described, therefore it can be of use for future diagnostic instrument developers, curriculum developers and educators.

In clinical practice, identifying positive and negative attitudes toward older patients is very important to improve quality of care provided to them. The Older People in Acute Care Survey - United States (OPACS-US) is an instrument measuring hospital nurses attitudes regarding older patients. However, psychometrics have never been assessed. Furthermore, knowledge being related to attitude and behavior should also be measured complementing the OPACS-US. The purpose of this study was to assess structural validity and reliability of the OPACS-US and assess whether the OPACS-US can be complemented with the Knowledge about Older Patients-Quiz (KOP-Q). A multicenter cross sectional design was conducted. Registered nurses (n = 130, mean age 39,9 years; working experience 14,6 years) working in four general hospitals were included in the study. Nurses completed the OPACS-US section A: practice experiences, B: general opinion and the KOP-Q online. Findings demonstrated that the OPACS-US is a valid and reliable survey instrument that measures practice experiences and general opinion. Furthermore, the OPACS-US can be combined with the KOP-Q adding a knowledge construct, and is ready for use within education and/or quality improvement programs in the USA.

Background: Stigmata on older people in society remains a big problem in the whole of Europe. It can lead to a lower self-esteem and is even as sociated with higher suicide rates. This study questioned whether the identification with one’s own age group is associated with an individual’s perceived stigma on the group of 70+, which has been unexamined so far for European citizens. Method: Data were derived from the European Social Survey (ESS). The sample consisted of 7878 persons aged 70+ stratified by three age groups. Group 1 = 70 – 75, Group 2= 76 – 80 and Group 3= >80. Independent T-test and Multiple regression analyses were used to examine influence of perceived stigmata in society on identification with one’s own age group, controlled for the covariates gender, household’s income, education, subjective general health, limitations in activities of daily life, marital status, having children living at home and having children not living at home. Results: A significant association was found for Group 1 (70 – 75) and Group 2 (76 – 80). Participants of these age groups, who reported a higher perception of stigmata for older people (70+), identified themselves less with their age group. No significant effect was found for Group 3 (people 80+). Conclusion: The results suggest that people older than 80 are less affected by stigmata of society on old age than younger groups (aged 70 - 80). Future research is necessary to examine the mechanisms which lead to a lower identification with their age of people aged 70 to 80.