Quality of care for cancer patients on home parenteral nutrition: Development of key interventions and outcome indicators using a two-round Delphi approach

Purpose: Clear recommendations on how to guide patients with cancer on home parenteral nutrition (HPN) are lacking as the use of HPN in this population remains a controversial issue. Therefore, the aims of this study were to rank treatment recommendations and main outcome indicators to ensure high-quality care and to indicate differences in care concerning benign versus malignant patients. Methods: Treatment recommendations, identified from published guidelines, were used as a starting point for a two-round Delphi approach. Comments and additional interventions proposed in the first round were reevaluated in the second round. Ordinal logistic regression with SPSS 2.0 was used to identify differences in care concerning benign versus malignant patients. Results: Twenty-seven experts from five European countries completed two Delphi rounds. After the second Delphi round, the top three most important outcome indicators were (1) quality of life (QoL), (2) incidence of hospital readmission and (3) incidence of catheter-related infections. Forty-two interventions were considered as important for quality of care (28/42 based on published guidelines; 14/42 newly suggested by Delphi panel). The topics 'Liver disease' and 'Metabolic bone disease' were considered less important for cancer patients, together with use of infusion pumps (p = 0.004) and monitoring of vitamins and trace elements (p = 0.000). Monitoring of QoL is considered more important for cancer patients (p = 0.03). Conclusion: Using a two-round Delphi approach, we developed a minimal set of 42 interventions that may be used to determine quality of care in HPN patients with malignancies. This set of interventions differs from a similar set developed for benign patients. © 2012 Springer-Verlag Berlin Heidelberg.

Multi-touch accceptance: perceived disorientation and consequences on task engagement

The research project takes place within the technology acceptability framework which tries to understand the use made of new technologies, and concentrates more specifically on the factors that influence multi-touch devices’ (MTD) acceptance and intention to use. Why be interested in MTD? Nowadays, this technology is used in all kinds of human activities, e.g. leisure, study or work activities (Rogowski and Saeed, 2012). However, the handling or the data entry by means of gestures on multi-touch-sensitive screen imposes a number of constraints and consequences which remain mostly unknown (Park and Han, 2013). Currently, few researches in ergonomic psychology wonder about the implications of these new human-computer interactions on task fulfillment.This research project aims to investigate the cognitive, sensori-motor and motivational processes taking place during the use of those devices. The project will analyze the influences of the use of gestures and the type of gesture used: simple or complex gestures (Lao, Heng, Zhang, Ling, and Wang, 2009), as well as the personal self-efficacy feeling in the use of MTD on task engagement, attention mechanisms and perceived disorientation (Chen, Linen, Yen, and Linn, 2011) when confronted to the use of MTD. For that purpose, the various above-mentioned concepts will be measured within a usability laboratory (U-Lab) with self-reported methods (questionnaires) and objective indicators (physiological indicators, eye tracking). Globally, the whole research aims to understand the processes at stakes, as well as advantages and inconveniences of this new technology, to favor a better compatibility and adequacy between gestures, executed tasks and MTD. The conclusions will allow some recommendations for the use of the DMT in specific contexts (e.g. learning context).