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BackgroundInjecting drug users are at increased risk for harmful effects compared to non-injecting drug users. Some studies have focused on differences in characteristics between these two groups (e.g., housing, overall health). However, no study has investigated the specific Dutch situation which in the last years has seen a decrease in homelessness among problematic hard-drug users and an increasing focus on physical health in low-threshold addiction care. The purpose of this study was to determine differences in sociodemographic, drug use and health characteristics between never-injecting (NIDUs), former-injecting (FIDUs) and current-injecting drug users (IDUs) and describe injecting practices.MethodsA total of 202 problematic hard-drug users (NIDU = 64; FIDU = 76; IDU = 62) were recruited from 22 low-threshold care facilities, including drug consumption rooms, methadone maintenance treatment, heroin-assisted therapy, day shelter and/or night shelter, supported housing and day activity centres. Data were collected on-site through structured face-to-face interviews.ResultsResults indicate that IDUs represented a separate group of problematic hard-drug users, with distinct sociodemographic and drug use characteristics. Overall, IDUs appeared to be the group with least favourable characteristics (unstable housing/homelessness, illegal activities, polydrug use) and NIDUs appeared to have the most favourable characteristics (stable housing, help with debts, less polydrug use). The FIDU group lies somewhere in between. The three groups did not differ significantly in terms of health. Regarding injecting practices, results showed that majority of IDUs had injected drugs for over 10 years and IDUs injected heroin, cocaine, amphetamine and/or methadone in the past 6 months. Sharing syringes was not common. A quarter reported public injecting.ConclusionsUnstable housing and homelessness are related to (former) injecting drug use, and stable housing is related to never-injecting drug use. Our study suggests that the number of ‘new’ IDUs is low. However, public injecting among IDUs is not uncommon and is associated with unstable housing. This emphasizes the potential of housing projects as a component of harm reduction measures. Therefore, prevention of (risks associated with) injecting drug use and supported housing programmes for problematic hard-drug users deserve the continuous attention of policymakers and professionals in low-threshold addiction care.

BackgroundTo prevent COVID-19 from spreading in long-term care facilities (LTCFs), the Dutch government took national restrictive measures, including a visitor-ban in LTCFs between mid-March and May 2020.Physical visits were replaced by alternatives as telephone or video calls. This study examines the relationship between the involvement of family caregivers (informal caregivers, ICs) of people with dementia (PwD) living in LTCFs and IC mental health during the visitor-ban. Furthermore, we examine whether this relationship is moderated by the frequency of contact with PwD during the visitor-ban and resilience of ICs.MethodsA cross-sectional study was carried out, 375 Dutch long-term care organizations were invited by email to participate. LTCFs sent eligible ICs a link to an anonymous online survey. Family involvement was assessed by the visiting frequency and doing social (e.g. drinking coffee), or social and task-related (e.g. laundry) activities during visits before the visitor-ban.Results958 ICs of PwD participated. Contact frequency increased for 17% ICs and decreased for 25% compared to visiting frequency. 43% of ICs did only social activities and 57% social and task-related activities. ICs who visited their relatives at least once a week before the visitor-ban were more worried during the visitor-ban than those with less regular visits (main effect). Contact frequency during the visitor-ban was a moderating factor, ICs who visited the PwD daily before, but had at least weekly contact during the visitor-ban, worried less. No main effects for activity type were found on loneliness , however resilience was a moderating factor. Resilient ICs who did more diverse activities (task and social related) before the visitor-ban, experienced less loneliness during the visitor ban.ConclusionsThe results implicate that to reduce worries amongst ICs, LTCFs should facilitate in continuing contact with PwD during a visitor-ban, specifically in highly involved ICs. Also, non-resilient ICs that generally only do social activities are more prone to loneliness. It is advisable for healthcare and welfare professionals to reach out to this group, to help them with overcoming their loneliness.

Introduction Healthcare professionals working with people with dementia (PwD) have increasingly been moving away from task-oriented models of healthcare towards a more person-centered care (PCC) model. Several studies have showed positive results of PCC on the quality of life of PwD. Also, it shows positive effects on self -esteem and work satisfaction of healthcare professionals. An effective way to educate professionals in PCC and improve their knowledge and person-centered attitude is by using online learning tools.We developed an e-learning in co-creation with end users focusing on well-being and (changing) behavior of PwD. The interactive e-learning supports healthcare professionals in developing a person-centered attitude, by using practical videos and exercises.Methods In the current pilot study, the e-learning is evaluated. To date, 33 healthcare professionals working in Dutch care homes from different care organizations participated in the study and completed the e-learning. In addition, they filled in online questionnaires before and after completing the e-learning. The questionnaires include the Approach to Dementia Questionnaire, Dementia Knowledge, Person Centered Care, Sense of Competence in Dementia Care Questionnaire. Post-measurement also included questions about satisfaction with the e-learning and user-friendliness.Results The final participants are currently completing their post-measurement questionnaires and final results are expected in September 2019. Preliminary data-analysis shows promising results. Positive effects on knowledge about dementia, person-centered attitude and sense of competence are expected. Also, user-friendliness, especially the flexibility of the e-learning (being able to follow the e-learning at home or at work and being able to stop and continue at any time) and the practice-oriented videos are positively evaluated.Conclusion Preliminary results of this pilot study suggest that the e-learning might contribute to developing a more person-centered attitude in healthcare professionals and indicate that participants have positive experiences with the e-learning module.