Pain Associated with Wound Care Treatment among Buruli Ulcer Patients from Ghana and Benin.

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Pain Associated with Wound Care Treatment among Buruli Ulcer Patients from Ghana and Benin.

PLoS One. 2015;10(6):e0119926

Authors: Alferink M, de Zeeuw J, Sopoh G, Agossadou C, Abass KM, Phillips RO, Loth S, Jutten E, Barogui YT, Stewart RE, van der Werf TS, Stienstra Y, Ranchor AV

Abstract
Buruli ulcer (BU) is a necrotizing skin disease caused by Mycobacterium ulcerans. People living in remote areas in tropical Sub Saharan Africa are mostly affected. Wound care is an important component of BU management; this often needs to be extended for months after the initial antibiotic treatment. BU is reported in the literature as being painless, however clinical observations revealed that some patients experienced pain during wound care. This was the first study on pain intensity during and after wound care in BU patients and factors associated with pain. In Ghana and Benin, 52 BU patients above 5 years of age and their relatives were included between December 2012 and May 2014. Information on pain intensity during and after wound care was obtained during two consecutive weeks using the Wong-Baker Pain Scale. Median pain intensity during wound care was in the lower range (Mdn = 2, CV = 1), but severe pain (score > 6) was reported in nearly 30% of the patients. Nevertheless, only one patient received pain medication. Pain declined over time to low scores 2 hours after treatment. Factors associated with higher self-reported pain scores were; male gender, fear prior to treatment, pain during the night prior to treatment, and pain caused by cleaning the wound. The general idea that BU is painless is incorrect for the wound care procedure. This procedural pain deserves attention and appropriate intervention.

PMID: 26030764 [PubMed – indexed for MEDLINE]

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Antibiotic information application offers nurses quick support.

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Antibiotic information application offers nurses quick support.

Am J Infect Control. 2016 Feb 19;

Authors: Wentzel J, van Drie-Pierik R, Nijdam L, Geesing J, Sanderman R, van Gemert-Pijnen JE

Abstract
BACKGROUND: Nurses can be crucial contributors to antibiotic stewardship programs (ASPs), interventions aimed at improving antibiotic use, but nurse empowerment in ASPs adds to their job complexity. Nurses work in complex settings with high cognitive loads, which ask for easily accessible information. An information application (app) was developed to support nurses in ASPs. The efficiency, effectiveness, and user satisfaction regarding this antibiotic app were tested in a pilot study.
METHODS: The app was introduced into 2 lung wards of a local teaching hospital. During the 8-month pilot study, the 62 nurses of the wards had access to the app. Changes in user satisfaction regarding information support, safety attitudes, and ASP behavior were assessed with a questionnaire. At baseline, 28 nurses completed the (e-mail) questionnaire; after the study, 18 nurses participated. Scenario-based tests were done to assess app efficiency and effectiveness at baseline (n = 16) and in a randomized control (without the app, n = 17) and intervention condition (with the app, n = 17).
RESULTS: Significant improvements were found regarding task support (P = .041), reliability (P = .004), unobtrusiveness (P = .000), relevance (P = .002), user friendliness (P = .000), speed, and hyperlinks (P = .001). An improvement in communication was observed regarding nurse-physician understanding (P = .034). With the app, nurses solved the scenarios faster than without it.
CONCLUSIONS: The human-centered design approach and persuasive strategy of task support were effective in reducing time needed to find information. Stewardship-related behaviors need active education strategies.

PMID: 26905792 [PubMed – as supplied by publisher]

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The buffering effect of family functioning on the psychological consequences of headache.

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The buffering effect of family functioning on the psychological consequences of headache.

Psychol Health Med. 2016 Feb 17;:1-7

Authors: Mohammadi S, Zandieh S, Dehghani M, Assarzadegan F, Sanderman R, Hagedoorn M

Abstract
The current study aimed to examine whether high family functioning mitigates the association between headache intensity and distress. The sample consisted of 124 patients with chronic or recurrent headache. Patients completed validated questionnaires about headache intensity, family functioning, and distress. Hierarchical regression analyses were performed to examine the interaction between headache intensity and family functioning on distress. Headache intensity was positively associated with distress (r = .28, p = .002). As hypothesized, family functioning moderated this association (B = -.01, p = .023). More specifically, the positive association between headache intensity and distress was significant only among patients with lower family functioning (B = .01, p < .001) and not among patients with higher levels of family functioning (B = .006, p = .075). Functional families appear to buffer the distress level in patients; they showed relatively low levels of distress regardless of the severity of their headache. In contrast, patients with dysfunctional families who experienced more pain reported more distress, presumably because they did not receive adequate help and support from these families. This study underlines the importance of a broader perspective on family dynamics in coping with pain.

PMID: 26885696 [PubMed – as supplied by publisher]

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Psychological burden at the time of diagnosis among Mexican breast cancer patients.

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Psychological burden at the time of diagnosis among Mexican breast cancer patients.

Psychooncology. 2016 Feb 12;

Authors: Pérez-Fortis A, Schroevers MJ, Fleer J, Alanís-López P, Veloz-Martínez MG, Ornelas-Mejorada RE, Sanderman R, Ranchor AV, Sánchez Sosa JJ

PMID: 26872293 [PubMed – as supplied by publisher]

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Patient satisfaction with a teleradiology service in general practice.

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Patient satisfaction with a teleradiology service in general practice.

BMC Fam Pract. 2016;17(1):17

Authors: Jacobs JJ, Ekkelboom R, Jacobs JP, van der Molen T, Sanderman R

Abstract
BACKGROUND: Accessibility to secondary health services is not always easy for patients who live at a great distance of hospital. In these circumstances, transferring diagnostic tools and treatment options to primary care could prove beneficial for patients. To do so, the quality of medical care and the costs and benefits of the approach need to be assessed. However, the patient perspective is equally important, offering important insights.
METHODS: In a cross-sectional study we investigate the satisfaction of patients toward a new teleradiology facility offered a general practice on Ameland, an island in the Netherlands. A questionnaire was created based on the Dutch version of the Patient Satisfaction Questionnaire III and completed by all patients after receiving an x-ray in primary care between June 1, 2007 and June 1, 2009. Those who received more than one x-ray in that period were included only once. The technical and interpersonal skills of doctors were rated out the sum score of the questionnaire namely 25 and 30, respectively. Analysis of variance (ANOVA) was used to analyze the differences between the means of the satisfaction subscales and the patient characteristics.
RESULTS: The response proportion was after reminder 65 % (381/587 patients). Satisfaction with the technical skills of the doctor providing the teleradiology service was 22.4 ± 3.7, while satisfaction with the interpersonal skills of the doctor during the diagnostic phase was 26.8 ± 3.8. Island residents, the elderly, and those with no history of trauma were more satisfied with the technical and interpersonal aspects of the consultation than non-residents, younger patients, and those with a history of trauma.
CONCLUSION: Patients in the island community of Ameland experienced high levels of satisfaction with the teleradiology service offered in primary care.

PMID: 26864118 [PubMed – in process]

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Fracture diagnostics, unnecessary travel and treatment: a comparative study before and after the introduction of teleradiology in a remote general practice.

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Fracture diagnostics, unnecessary travel and treatment: a comparative study before and after the introduction of teleradiology in a remote general practice.

BMC Fam Pract. 2015;16:53

Authors: Jacobs JJ, Jacobs JP, van Sonderen E, van der Molen T, Sanderman R

Abstract
BACKGROUND: Teleradiology entails attainment of x-rays in one location, transfer over some distance and assessment at another location for diagnosis or consultation. This study documents fracture diagnostics, unnecessary trips to the hospital, treatment and number of x-rays for the years 2006 and 2009, before and after the introduction of teleradiology in a general practice on the island of Ameland in the north of the Netherlands.
METHODS: In a retrospective, descriptive, observational before and after study of the introduction of x-ray facilities in an island-based general practice, we compared the number of accurately diagnosed fractures, unnecessary trips, treatments and number of x-rays taken in 2006 when only a hospital x-ray facility was available 5 hours away with those in 2009 after an x-ray facility became available at a local general practice. All patients visiting a general practice on the island of Ameland in 2006 and 2009 with trauma and clinical suspicion of a fracture, dislocation or sprain were included in the study. The initial clinical diagnoses, including those based on the outcomes of x-rays, were compared for the two years and also whether the patients were treated at home or in hospital.
RESULTS: A total of 316 and 490 patients with trauma visited a general practice in 2006 and 2009, respectively. Of these patients, 66 and 116 were found to have fractures or dislocations in the two years, respectively. In 2006, 83 x-rays were ordered; in 2009, this was 284. In 2006, 9 fractures were missed; in 2009, this was only 2. In 2006, 15 patients with fractures or dislocations were treated at the general practice; in 2009, this had increased to 77.
CONCLUSION: Since the introduction of teleradiology the number of missed fractures in patients visiting the general practice with trauma and the number of the unnecessary trips to a hospital are reduced. In addition more patients with fractures and dislocations can be treated in the general practice as opposed to the hospital.

PMID: 25943473 [PubMed – indexed for MEDLINE]

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Trajectories of personal control in cancer patients receiving psychological care.

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Trajectories of personal control in cancer patients receiving psychological care.

Psychooncology. 2015 May;24(5):556-63

Authors: Zhu L, Schroevers MJ, van der Lee M, Garssen B, Stewart RE, Sanderman R, Ranchor AV

Abstract
OBJECTIVE: This study aimed to (1) identify subgroups of cancer patients with distinct personal control trajectories during psychological care, (2) examine whether socio-demographic, clinical, and psychological care characteristics could distinguish trajectories, and (3) examine differential patterns of psychological symptoms between trajectories.
METHODS: This naturalistic study focused on 241 cancer patients receiving psychological care at psycho-oncology institutions. Data were collected before the initiation of psychological care, and 3 and 9 months thereafter. Latent class growth analysis was applied to identify personal control trajectories.
RESULTS: Three personal control trajectories were identified: enduring improvement (41%), temporary improvement (50%), and deterioration (9%). Education and baseline physical symptoms distinguished these trajectories. In the whole group, improvements in personal control were associated with improvements in psychological symptoms. Patients at distinct trajectories reported different levels of psychological symptoms, but did not differ in their courses of psychological symptoms. Patients in the enduring and temporary control improvement groups experienced significant psychological symptoms reductions over time, whereas patients in the control deterioration group maintained high psychological symptoms.
CONCLUSIONS: Improvements in personal control seem to depend on initial control level: those who start with the highest control levels show subsequent improvements, whereas those with the lowest control levels show subsequent deterioration.

PMID: 25251894 [PubMed – indexed for MEDLINE]

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Results of the PACE follow-up study are uninterpretable.

Results of the PACE follow-up study are uninterpretable.

Lancet Psychiatry. 2016 Jan 18;

Authors: Coyne JC, Laws KR

PMID: 26795757 [PubMed – as supplied by publisher]

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Online genetic counseling from the providers’ perspective: counselors’ evaluations and a time and cost analysis.

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Online genetic counseling from the providers’ perspective: counselors’ evaluations and a time and cost analysis.

Eur J Hum Genet. 2016 Jan 20;

Authors: Otten E, Birnie E, Ranchor AV, van Langen IM

Abstract
Telemedicine applications are increasingly being introduced in patient care in various disciplines, including clinical genetics, mainly to increase access to care and to reduce time and costs for patients and professionals. Most telegenetics reports describe applications in large geographical areas, showing positive patients’ and professionals’ satisfaction. One economic analysis published thus far reported lower costs than in-person care. We hypothesized that telegenetics can also be beneficial from the professional’s view in relatively small geographical areas. We performed a pilot study in the Northern Netherlands of 51 home-based online counseling sessions for cardiogenetic and oncogenetic cascade screening, and urgent prenatal counseling. Previously, we showed patient satisfaction, anxiety, and perceived control of online counseling to be comparable to in-person counseling. This study focuses on expectations, satisfaction, and practical evaluations of the involved counselors, and the impact in terms of time and costs. Most counselors expected disadvantages of online counseling for themselves and their patients, mainly concerning insufficient non-verbal communication; few expected advantages for themselves. Afterwards, counselors additionally raised the disadvantage of insufficient verbal communication, and reported frequent technical problems. Their overall mean telemedicine satisfaction itemscore was 3.38 before, and 2.95 afterwards, being afterwards slightly below the minimum level we set for a satisfactory result. We estimated reduced time and costs by online counseling with about 8% and 10-12%, respectively. We showed online genetic counseling to be effective, feasible and cost-efficient, but technical improvements are needed to increase counselors’ satisfaction.European Journal of Human Genetics advance online publication, 20 January 2016; doi:10.1038/ejhg.2015.283.

PMID: 26785833 [PubMed – as supplied by publisher]

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Role of patient treatment beliefs and provider characteristics in establishing patient-provider relationships.

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Role of patient treatment beliefs and provider characteristics in establishing patient-provider relationships.

Fam Pract. 2015 Apr;32(2):224-31

Authors: Lee King PA, Cederbaum JA, Kurzban S, Norton T, Palmer SC, Coyne JC

Abstract
BACKGROUND: Positive patient-provider relationships have been associated with improved depression treatment outcomes. Little is known about how patient treatment beliefs influence patient-provider relationships, specifically treatment alliance and shared decision making in primary care (PC).
OBJECTIVE: We evaluated the relationship between patient treatment beliefs and patient-provider relationships by gender, race and current depression.
METHODS: We used a deductive parallel convergent mixed method design with cross-sectional data. Participants were 227 Black and White patients presenting with depression symptoms in PC settings. Individuals were randomized into either a quantitative survey (n = 198) or qualitative interview (n = 29) group. We used multiple ordinary least squares regression to evaluate the association between patient beliefs, as measured by the Treatment Beliefs Scale and the Medication Beliefs Scale, and treatment alliance or shared decision making. We concurrently conducted thematic analyses of qualitative semistructured interview data to explicate the nature of patient-provider relationships.
RESULTS: We found that patients who believed their provider would respectfully facilitate depression treatment reported greater bond, openness and shared decision making with their provider. We also identified qualitative themes of physicians listening to, caring about and respecting patients. Empathy and emotive expression increased patient trust in PC providers as facilitators of depression treatment.
CONCLUSIONS: This work systematically demonstrated what many providers anecdotally believe: PC environments in which individuals feel safe sharing psychological distress are essential to early identification and treatment of depression. Interprofessional skills-based training in attentiveness and active listening may influence the effectiveness of depression intervention.

PMID: 25556196 [PubMed – indexed for MEDLINE]

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