Monthly Archives: October 2014

Distress, problems and referral wish of cancer patients: differences according to relationship status and life phase.






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Distress, problems and referral wish of cancer patients: differences according to relationship status and life phase.

Psychooncology. 2014 Oct 24;

Authors: Tuinman MA, Van Nuenen FM, Hagedoorn M, Hoekstra-Weebers JE

Abstract
OBJECTIVE: The aim of this study is to examine differences in distress, problems and referral wish in cancer patients according to relationship status and life phase.
METHODS: A cross-sectional group of 1340 patients (response = 51%) completed socio-demographic and illness-related questions, and the Dutch version of the Distress Thermometer and Problem List that also assesses desire for additional care (yes, maybe and no). Relationship status was categorized into six groups (married, cohabiting, LAT (=living-apart-together: have a partner but live alone), divorced, widowed or single) and age into young (18-50), middle aged (51-65) and older (65+) cohorts.
RESULTS: Relationship status and life phase were independently related to high distress, referral wish and accordance between the latter two. Single and LAT patients were around two times more likely than married patients to be highly distressed, and wanting additional care. The same was found for younger patients as compared to 65+ patients. Whereas high distress is usually not a strong indication for additional care needs, single, LAT and younger patients most often wanted care when they were highly distressed.
CONCLUSION: Health care professionals who implement distress screening in practice can expect a higher need for additional care in single and LAT patients, but only when they are younger or middle aged. The benefit of having a partner around on a daily basis seems less important in dealing with cancer-related problems when patients are older. Copyright © 2014 John Wiley & Sons, Ltd.

PMID: 25345693 [PubMed – as supplied by publisher]

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[Teleradiology in a family practice on the Dutch island of Ameland: a cost-benefit analysis].






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[Teleradiology in a family practice on the Dutch island of Ameland: a cost-benefit analysis].

Ned Tijdschr Geneeskd. 2013;156(51):A5428

Authors: Jacobs JJ, Jacobs JP, Wiersma D, Sanderman R

Abstract
OBJECTIVE: To calculate the costs and benefits of the introduction of teleradiology at a general practice on the Dutch island of Ameland from the perspectives of three different entities: (a) the family doctor (investor); (b) patients; and (c) health insurance companies.
DESIGN: Descriptive, cost-benefit analysis.
METHOD: For the year 2009, one and a half years after the introduction of a teleradiology facility at a general practice in Ameland, the operational and financing costs, the patient’s saved travel time and expenses and the teleradiology costs for health insurance companies were compared with the costs that would have been made without teleradiology.
RESULTS: In 2009, 426 X-rays had been taken at the general practice of which 241 for trauma and 185 for non-traumatic cases. With a reimbursement of € 100 per X-ray taken during normal working hours and € 200 for those taken during evenings and weekends, benefits for the family doctor (investor) were € 46,698 and the costs amounted to € 45,710, or a positive balance of € 980. Patients’ savings in travel time and expenses were calculated at € 111,068. Health insurance companies reimbursed a minimum of € 89,265 less on diagnosis and treatment.
CONCLUSION: The introduction of teleradiology a general practice in Ameland resulted in a considerable cost reduction for patients as well as for health insurance companies. In the future, diagnosing in this manner could be expanded in particular to regions in which the distances to hospitals are greater: a part of secondary healthcare could be conducted at a reduced cost.

PMID: 24472309 [PubMed – indexed for MEDLINE]

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Development of a brief questionnaire (ICQ-S) to monitor inhaled corticosteroid side-effects in clinical practice.






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Development of a brief questionnaire (ICQ-S) to monitor inhaled corticosteroid side-effects in clinical practice.

Allergy. 2014 Mar;69(3):372-9

Authors: Foster JM, Schokker S, Sanderman R, Postma DS, van der Molen T

Abstract
BACKGROUND: Side-effect concerns impede adherence with inhaled corticosteroids (ICS) and often underlie poor asthma control. We developed a brief version (ICQ-S) of the 57-item Inhaled Corticosteroids side-effect Questionnaire (ICQ) to facilitate side-effect monitoring in busy clinics.
METHODS: Part 1: After completion by 482 patients with doctor-diagnosed asthma, each ICQ item underwent item reduction analysis. Part 2: Patients prescribed ICS for asthma completed the ICQ at baseline (BL), ICQ-S at day 14 (D14) and day 28 (D28), and 6-item Asthma Control Questionnaire (ACQ) and Mini Asthma Quality of Life Questionnaire (MiniAQLQ) at BL, D14 and D28. 14-day test-retest reliability was assessed by intraclass correlation coefficient (ICC) between ICQ-S scores and internal consistency by Cronbach’s alpha (α) coefficient and item-total correlations of ICQ-S. Criterion validity was assessed by correlations (Spearman’s rho) between ICQ and ICQ-S total score. Patients reported duration and difficulty of ICQ-S completion at D28.
RESULTS: Part 1: The ICQ-S consists of fifteen local/systemic ICS side-effects of similar range to the full ICQ. Part 2: 62 asthma patients (mean ACQ score 0.79 ± SD 0.83) prescribed daily ICS [BDP-equivalent median dose 1000 μg (IQR: 500, 1000)] participated. ICC between ICQ-S scores was 0.90. All item-total correlations were rho ≥ 0.20. The ICQ-S demonstrated criterion validity, for example, ICQ and ICQ-S were strongly associated (rho = 0.86). 81% of patients completed the ICQ-S within 5 minutes and 97% found completion ‘not difficult’.
CONCLUSION: The ICQ-S is a brief, patient-friendly tool with good reliability and validity, which may be useful for monitoring ICS side-effects in clinical practice.

PMID: 24444382 [PubMed – indexed for MEDLINE]

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Mindfulness, acceptance and catastrophizing in chronic pain.






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Mindfulness, acceptance and catastrophizing in chronic pain.
PLoS One. 2014;9(1):e87445
Authors: de Boer MJ, Steinhagen HE, Versteegen GJ, Struys MM, Sanderman R
Abstract
OBJECTIVES:… Continue reading

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A prospective analysis on fatigue and experienced burden in informal caregivers of cancer patients during cancer treatment in the palliative phase.






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A prospective analysis on fatigue and experienced burden in informal caregivers of cancer patients during cancer treatment in the palliative phase.

Acta Oncol. 2014 Oct 7;:1-7

Authors: Peters ME, Goedendorp MM, Verhagen SA, Smilde TJ, Bleijenberg G, van der Graaf WT

Abstract
Background. Although fatigue is the most frequently occurring symptom in patients with cancer, hardly anything is known about fatigue of their informal caregivers and the impact fatigue might have on perceived burden with providing care. We investigated the presence of fatigue in caregivers, its course and the relation of fatigue severity between caregivers and patients. Furthermore, we explored in caregivers whether fatigue severity was correlated to experienced burden. Material and methods. Informal caregivers and patients on cancer treatment in the palliative phase completed questionnaires at baseline and follow-up (6 months later). To measure fatigue severity, both groups completed the Checklist Individual Strength. Additionally, caregivers completed the Caregivers Strain Index to assess experienced burden with providing care. Descriptive analyses, paired t-tests, χ(2)-tests, Pearson’s correlations and regression analysis were performed. Results. At baseline 111 couples (patients and caregivers) participated, at follow-up 75 couples. At both time points 23% of caregivers were severely fatigued. There was no significant correlation between patients and caregivers on fatigue. Higher fatigue in both patients and caregivers was correlated with higher burden in caregivers and over 30% of burden could be explained by fatigue. Conclusion. Almost a quarter of caregivers of patients on active palliative treatment were severely fatigued, which figure remained stable over time. Fatigue in both patients and caregivers was related to caregivers’ burden. This observation should be taken into account with the growing demand on caregivers and the increase in cancer treatment options in the palliative setting.

PMID: 25291079 [PubMed – as supplied by publisher]

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The mediating role of disability and social support in the association between low vision and depressive symptoms in older adults.






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The mediating role of disability and social support in the association between low vision and depressive symptoms in older adults.

Qual Life Res. 2014 Apr;23(3):1039-43

Authors: Kempen GI, Ranchor AV, Ambergen T, Zijlstra GA

Abstract
PURPOSE: Vision loss is highly prevalent in old age and has a substantial impact on different aspects of quality of life including depressive symptoms. Our objective was to examine the mediating role of disability and social support in the association between low vision and depressive symptoms.
METHODS: Differences in disability, social support, and depressive symptoms between 148 persons with low vision and a reference population (N = 4,792) all ≥57 years were compared. The association between low vision and depressive symptoms and the mediating role of disability and social support was examined by the means of regression.
RESULTS: A significant effect of low vision on depressive symptoms was identified even after the adjustment for disability and social support (standardized beta 0.053, P < 0.001). The association between low vision and symptoms of depression was partially mediated by disability, while social support was identified as a suppressor variable. Low vision, disability, and social support showed unique contributions to depressive symptoms.
CONCLUSIONS: Prevention of disability and the increase in social support may help to reduce symptoms of depression in older adults with low vision. By taking such information into account in their intervention work, health professionals working in this area may improve their care quality.

PMID: 24081872 [PubMed – indexed for MEDLINE]

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