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ABSTRACT On October 4, 1992, the El Al Boeing crashed in the residential quarter ‘Bijlmermeer’ in Amsterdam (The Netherlands). In the years after the plane crash, local residents and assistance personnel began reporting a variety of... more
ABSTRACT On October 4, 1992, the El Al Boeing crashed in the residential quarter ‘Bijlmermeer’ in Amsterdam (The Netherlands). In the years after the plane crash, local residents and assistance personnel began reporting a variety of unusual symptoms not unlike those reported by patients with chronic fatigue syndrome (CFS) and Gulf War Syndrome (GWS). The aim of this study was to define the symptom constellations reported by the patients and assess the possible causes of the illness. Standardized psychological questionnaires (MMPI-II, SCL-90, KPS and a complaints checklist) were used to screen for psychological changes and to describe the symptoms reported by the patients. Differences between local residents and assistance personnel, gender differences, Mycoplasma-infected and Mycoplasma non-infected patients were monitored. The major symptoms reported were extreme fatigue, non-restorative sleep, concentration-problems, memory problems and muscle and joint pains. There were no changes in the SCL-90 responses that indicated any alteration of psychological distress. Assessment using the MMPI-II revealed a profile typically seen in chronic physical illness and assessment of the Harris-Lingoes scales revealed no elevations in pathogenic scales. Twelve subjects (67%) had a positive Mycoplasma PCR response. Victims of the Bijlmermeer plane crash disaster had increases in symptoms similar to patients with Gulf War Syndrome and CFS and no evidence of somatoform disorder, anxiety or depression. Similar to patients with Gulf War Syndrome and CFS, a deregulation of the immune-competence through a combination of toxic material exposure and psychological stressors associated with increased opportunistic infections may be the most likely etiological hypothesis.
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ABSTRACT Objective: Chronic fatigue syndrome (CFS) functionally impairs many patients. Despite numerous studies and reviews in CFS, little is known about the behavioral consequences. Several researchers have already suggested the... more
ABSTRACT Objective: Chronic fatigue syndrome (CFS) functionally impairs many patients. Despite numerous studies and reviews in CFS, little is known about the behavioral consequences. Several researchers have already suggested the influential role of personality as a possible predisposing or perpetuating factor. Method: A case study is presented of a 34-year-old man with a history of CFS. Psychological profiling using the MMPI-2 was performed during the course of his condition. Results: His passive-aggressive manner during the medical encounter was underscored by his personality profile (code type 3-2). After his recovery, however, a spike 3 profile emerged indicating a fulfilled individual. Somatic items included in the inventory, created a secondary increase of the clinical scales. Physical complaints diminished as his condition improved and subsequently, decreased the clinical scales. Conclusion: The relevance of classifying personality characteristics in CFS patients as traits could not be supported by this case report.
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Aim of the present study was to compare chronic fatigue syndrome (CFS) patients, attending 2... more
Aim of the present study was to compare chronic fatigue syndrome (CFS) patients, attending 2 "ideologically" contrasting clinics for CFS, on various patient and illness characteristics. Fifty-nine CFS patients of each clinic, located in Leuven and Brussels (Belgium), participated. Patients did not differ with regard to age, levels of fatigue, psychopathology, and self-efficacy. However, patients from the psychosocially-oriented clinic had a lower level of education, reported more progressive illness onset, and attributed their illness more to psychological causes. Patients in the biologically-oriented clinic reported more pain, and showed higher levels of social functioning, motivation and vitality, as well as fewer limitations related to emotional problems. It is concluded that CFS patients attending the 2 clinics could not be distinguished along dualistic biological/psychosocial lines, but those reporting sudden illness onset and making somatic attributions were more likely to be represented in the biologically-oriented clinic.
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Purpose An increasing number of breast cancer (BC) survivors of working age require return to work (RTW) support. Objective of this paper is to describe the development of a RTW intervention to be embedded in the care process bridging the... more
Purpose An increasing number of breast cancer (BC) survivors of working age require return to work (RTW) support. Objective of this paper is to describe the development of a RTW intervention to be embedded in the care process bridging the gap between hospital and workplace. Method The Intervention Mapping (IM) approach was used and combined formative research results regarding RTW in BC patients with published insights on occupational therapy (OT) and RTW. Four development steps were taken, starting from needs assessment to the development of intervention components and materials. Results A five-phased RTW intervention guided by a hospital-based occupational therapist is proposed: (1) assessing the worker, the usual work and contextual factors which impacts on (re-)employment; (2) exploration of match/differences between the worker and the usual work; (3) establishing long term goals, broken down into short term goals; (4) setting up tailored actions by carefully implementing results of preceding phases; (5) step by step, the program as described in phase 4 will be executed. The occupational therapist monitors, measures and reviews goals and program-steps in the intervention to secure the tailor-made approach of each program-step of the intervention. Conclusion The use of IM resulted in a RTW oriented OT intervention. This unique intervention succeeds in matching individual BC patient needs, the input of stakeholders at the hospital and the workplace.
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The primary aim of this review study was to gather evidence on the effectiveness in terms of return to work (RTW) of occupational therapy interventions (OTIs) in rehabilitation patients with non-congenital disorders. A secondary aim was... more
The primary aim of this review study was to gather evidence on the effectiveness in terms of return to work (RTW) of occupational therapy interventions (OTIs) in rehabilitation patients with non-congenital disorders. A secondary aim was to be able to select the most efficient OTI. A systematic literature review of peer-reviewed papers was conducted using electronic databases (Cinahl, Cochrane Library, Ebsco, Medline (Pubmed), and PsycInfo). The search focussed on randomised controlled trials and cohort studies published in English from 1980 until September 2010. Scientific validity of the studies was assessed. Starting from 1532 papers with pertinent titles, six studies met the quality criteria. Results show systematic reviewing of OTIs on RTW was challenging due to varying populations, different outcome measures, and poor descriptions of methodology. There is evidence that OTIs as part of rehabilitation programs, increase RTW rates, although the methodological evidence of most stud...
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This observational study aimed to adapt a computer-tailored step advice for the general population into a feasible advice for breast cancer survivors and to test its usability. First, several adaptations were made to the original design... more
This observational study aimed to adapt a computer-tailored step advice for the general population into a feasible advice for breast cancer survivors and to test its usability. First, several adaptations were made to the original design (adding cancer-related physical activity (PA) barriers and beliefs, and self-management strategies to improve survivors' personal control). Second, the adapted advice was evaluated in two phases: (1) a usability testing in healthy women (n = 3) and survivors (n = 6); and (2) a process evaluation during 3 weeks in breast cancer survivors (n = 8). Preliminary usability testing revealed no problems during logging-in; however, three survivors misinterpreted some questions. After refining the questionnaire and advice, survivors evaluated the advice as interesting, attractive to read, comprehensible and credible. Inactive survivors found the advice novel, but too long. The process evaluation indicated that the majority of the women (n = 5/8) reported i...
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When confronted with chronic fatigue syndrome (CFS), general practitioners (GPs) need to deal with diverse complaints. This may introduce a sense of powerlessness and frustration in the GP, which could possibly undermine the... more
When confronted with chronic fatigue syndrome (CFS), general practitioners (GPs) need to deal with diverse complaints. This may introduce a sense of powerlessness and frustration in the GP, which could possibly undermine the doctor-patient relationship. Our aim was to list the perspectives of patients with CFS regarding the medical encounter. This was a questionnaire study of systematically selected patients presenting to a tertiary clinic specialising in CFS. A questionnaire was presented to every third patient attending the clinic. Statistical computations were performed using the SPSS statistical package. One hundred and seventy-seven patients completed the questionnaire. A diagnosis of CFS was made by a GP in 8% of the cases. In 31% of the cases the GP had experience with general CFS complaints, and 35% of the GPs showed experience in CFS. Only 23% reported sufficient knowledge to treat the condition. According to the patients surveyed, 35% felt that their GP had experience in d...
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The Chronic Fatigue Syndrome-Activities and Participation Questionnaire (CFS-APQ) is a recently developed disease-specific assessment tool for monitoring activity limitations and participation restrictions in patients with chronic fatigue... more
The Chronic Fatigue Syndrome-Activities and Participation Questionnaire (CFS-APQ) is a recently developed disease-specific assessment tool for monitoring activity limitations and participation restrictions in patients with chronic fatigue syndrome (CFS). In this study, the convergent validity, content validity, and test-retest reliability of data obtained with the Dutch-language version of the questionnaire were examined. One hundred eleven consecutive patients with CFS were enrolled, of whom 47 fulfilled all inclusion criteria. The subjects were first asked to rate their pain, fatigue, and ability to concentrate using 3 visual analog scales, to list at least 5 activities that had become difficult to perform due to their complaints, and to complete the CFS-APQ. Furthermore, subjects were asked to complete a modified version of the CFS-APQ at home and return it to the investigators. The content of the questionnaire was reviewed using the World Health Organization's International ...
Research Interests: Psychometrics, Pain, Attention, Chronic Fatigue Syndrome, Fatigue, and 16 morePhysical Therapy, Activities of Daily Living, Humans, Female, Male, Netherlands, Physical, Health Status, Clinical Sciences, Middle Aged, Questionnaires, Adult, Reproducibility of Results, Cost of Illness, Pain Measurement, and Statistics as Topic
This study examined possible interactions between immunological abnormalities and symptoms in CFS. Sixteen CFS patients filled in a battery of questionnaires, evaluating daily functioning, and underwent venous blood sampling, in order to... more
This study examined possible interactions between immunological abnormalities and symptoms in CFS. Sixteen CFS patients filled in a battery of questionnaires, evaluating daily functioning, and underwent venous blood sampling, in order to analyse immunological abnormalities. Ribonuclease (RNase) L cleavage was associated with RNase L activity (rs=0.570; p=0.021), protein kinase R (PKR) (rs=0.716; p=0.002) and elastase activity (rs=0.500; p=0.049). RNase L activity was related to elastase (rs=0.547; p=0.028) and PKR activity (rs=0.625; p=0.010). RNase L activity (rs=0.535; p=0.033), elastase activity (rs=0.585; p=0.017) and RNase L cleavage (rs=0.521; p=0.038) correlated with daily functioning. This study suggests that in CFS patients an increase in elastase activity and subsequent RNase L cleavage is accompanied by increased activity of both the PKR and RNase L enzymes. RNase L and elastase activity are related to daily functioning, thus evidence supporting the clinical importance of...
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The objective was to establish the extent to which physical functioning capacity and self-report measures are able to predict the habitual walking performance in ambulatory persons with multiple sclerosis. Fifty persons with multiple... more
The objective was to establish the extent to which physical functioning capacity and self-report measures are able to predict the habitual walking performance in ambulatory persons with multiple sclerosis. Fifty persons with multiple sclerosis (Expanded Disability Status Scale, EDSS, 1.5-6.5) were tested on leg muscle strength as well as walking and balance capacity, and completed self-report indices on perceived physical functioning. Habitual walking performance, that is, the real amount of steps that is performed in the customary living environment, was registered by means of an ambulant accelerometer-based monitor during seven consecutive days. Mild (EDSS 1.5-4.0, n = 29) and moderate (EDSS 4.5-6.5, n = 21) multiple sclerosis subgroups were additionally distinguished as predictor variables and values were hypothesized to differ depending on multiple sclerosis severity and concomitant ambulatory function. Multiple regression analyses yielded a single most significant predictor for each (sub)group with other variables making no independent contribution to the variation in habitual walking performance. For the total study sample, this was the 6-Minute Walking Test (R(2) = 0.458, p < 0.01). In the mild multiple sclerosis subgroup, the 6-Minute Walking Test was again most predictive, yet to a modest degree (R(2) = 0. 187, p = 0.02). In the moderate multiple sclerosis subgroup, the 2-Minute Walking Test explained over half of the variance (R(2) = 0.532, p < 0.01). Habitual walking performance is best reflected by longer walking capacity tests. The extent to which it can be predicted based on clinical testing is larger in a multiple sclerosis patient sample with more severe walking disability. Ambulatory monitoring, however, includes aspects of community ambulation not captured in the clinic, and must be considered as an additional outcome for evaluating interventions in multiple sclerosis.
Research Interests: Research Design, Multiple sclerosis, Exercise therapy, Muscle strength, Humans, and 14 moreWalking, Female, Male, Health Status, Clinical Sciences, Aged, Middle Aged, Adult, Multiple, Ambulatory BP monitoring, Cross Sectional Studies, Neurosciences, Mobility limitation, and Severity of Illness Index
Research Interests: Flow Cytometry, Chronic Fatigue Syndrome, Medicine Science, Humans, Protein Kinases, and 20 moreNitric oxide, Female, Blood sampling, Heart rate, Oxygen Uptake, Exercise, Stress Testing, Middle Aged, Oxygen, Adult, Protein Kinase R, Regression Model, Western blot, Multiple regression analysis, Cross sectional Study, Medicine and Science In Sports and Exercise, Enzymatic Activity, Cross Sectional Studies, Exercise Test, and Respiratory exchange ratio
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Aim of the present study was to compare chronic fatigue syndrome (CFS) patients, attending 2... more
Aim of the present study was to compare chronic fatigue syndrome (CFS) patients, attending 2 "ideologically" contrasting clinics for CFS, on various patient and illness characteristics. Fifty-nine CFS patients of each clinic, located in Leuven and Brussels (Belgium), participated. Patients did not differ with regard to age, levels of fatigue, psychopathology, and self-efficacy. However, patients from the psychosocially-oriented clinic had a lower level of education, reported more progressive illness onset, and attributed their illness more to psychological causes. Patients in the biologically-oriented clinic reported more pain, and showed higher levels of social functioning, motivation and vitality, as well as fewer limitations related to emotional problems. It is concluded that CFS patients attending the 2 clinics could not be distinguished along dualistic biological/psychosocial lines, but those reporting sudden illness onset and making somatic attributions were more likely to be represented in the biologically-oriented clinic.
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ABSTRACT Fibromyalgia (FM) and Chronic Fatigue Syndrome (CFS) are related yet overlapping disorders; the current case definitions prohibit a clear-cut differential diagnosis. These diagnostic criteria mainly address the impairment level... more
ABSTRACT Fibromyalgia (FM) and Chronic Fatigue Syndrome (CFS) are related yet overlapping disorders; the current case definitions prohibit a clear-cut differential diagnosis. These diagnostic criteria mainly address the impairment level of the World Health Organization's International Classification of Functioning, Disability and Health. This study aimed at comparing activity limitations and participation restrictions in patients with FM (n = 90) and CFS (n = 47). The Chronic Fatigue Syndrome Activities and Participation Questionnaire (CFS-APQ) was used for assessing functionality in both groups. The convergent validity of the scores obtained with the questionnaire with visual analogue scales for pain, fatigue and concentration was investigated in FM patients, as well as the content validity. No differences in total scores and 25 out of 26 individual items on the CFS-APQ were observed between the 2 groups (independent samples Mann-Whitney U test). This sample of FM patients reported to be more disabled in ‘sitting for two hours’ as compared to the CFS group (mean scores 3.0 ± 1.0 and 2.3 ± 1.0; P = .004). Four hundred and thirty-seven of the 497 (87.9%) responses to the request to list difficult activities matched the content of the CFS-APQ. The overall scores of the CFS-APQ correlated statistically significant in respect to visual analogue scales for pain and concentration (Spearman rho for the total scores ranged between .44 and .49). These data question the disease specificity of the CFS-APQ for CFS, but suggests its applicability in ‘the Chronic Pain-Fatigue Syndromes.’ The present report provides evidence for both the content and convergent validity of the CFS-APQ in FM patients.
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ABSTRACT Objective: Chronic fatigue syndrome (CFS) functionally impairs many patients. Despite numerous studies and reviews in CFS, little is known about the behavioral consequences. Several researchers have already suggested the... more
ABSTRACT Objective: Chronic fatigue syndrome (CFS) functionally impairs many patients. Despite numerous studies and reviews in CFS, little is known about the behavioral consequences. Several researchers have already suggested the influential role of personality as a possible predisposing or perpetuating factor. Method: A case study is presented of a 34-year-old man with a history of CFS. Psychological profiling using the MMPI-2 was performed during the course of his condition. Results: His passive-aggressive manner during the medical encounter was underscored by his personality profile (code type 3-2). After his recovery, however, a spike 3 profile emerged indicating a fulfilled individual. Somatic items included in the inventory, created a secondary increase of the clinical scales. Physical complaints diminished as his condition improved and subsequently, decreased the clinical scales. Conclusion: The relevance of classifying personality characteristics in CFS patients as traits could not be supported by this case report.
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ABSTRACT All patients suffering from a chronic condition, are challenged to manage the reality of their disease, the accompanying anxiety, the problems of daily living, and the effect on relationships. Therefore, when confronted with... more
ABSTRACT All patients suffering from a chronic condition, are challenged to manage the reality of their disease, the accompanying anxiety, the problems of daily living, and the effect on relationships. Therefore, when confronted with debilitating complaints, patients suffering from chronic fatigue syndrome (CFS) need to adapt to a new way of living during the course of their illness. Fennell developed an integrated model to manage CFS. This article is a follow-up of a study by Jason et al. (9, 10) to verify the existence of the different phases. Although not all differences are statistically significant, a clear distinction is made according to the conclusions drawn by Jason et al. (9, 10). Relationships between these distinctions and measures of symptoms, disability, psychological distress, coping, and immune parameters were revealed using non-parametric statistical tests.
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Multidisciplinary teams (MDTs) are considered the gold standard of cancer care in many healthcare systems, but a clear definition of their format, scope of practice and operational criteria is still lacking. The aims of this review were... more
Multidisciplinary teams (MDTs) are considered the gold standard of cancer care in many healthcare systems, but a clear definition of their format, scope of practice and operational criteria is still lacking. The aims of this review were to assess the impact of MDTs on patient outcomes in cancer care and identify their objectives, organisation and ability to engage patients in their care. We conducted a systematic review of the literature in the Medline database. Fifty-one peer-reviewed papers were selected from November 2005 to June 2012. MDTs resulted in better clinical and process outcomes for cancer patients, with evidence of improved survival among colorectal, head and neck, breast, oesophageal and lung cancer patients in the study period. Also, it was observed that MDTs have been associated with changes in clinical diagnostic and treatment decision-making with respect to urological, pancreatic, gastro-oesophageal, breast, melanoma, bladder, colorectal, prostate, head and neck a...
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ABSTRACT On October 4, 1992, the El Al Boeing crashed in the residential quarter ‘Bijlmermeer’ in Amsterdam (The Netherlands). In the years after the plane crash, local residents and assistance personnel began reporting a variety of... more
ABSTRACT On October 4, 1992, the El Al Boeing crashed in the residential quarter ‘Bijlmermeer’ in Amsterdam (The Netherlands). In the years after the plane crash, local residents and assistance personnel began reporting a variety of unusual symptoms not unlike those reported by patients with chronic fatigue syndrome (CFS) and Gulf War Syndrome (GWS). The aim of this study was to define the symptom constellations reported by the patients and assess the possible causes of the illness. Standardized psychological questionnaires (MMPI-II, SCL-90, KPS and a complaints checklist) were used to screen for psychological changes and to describe the symptoms reported by the patients. Differences between local residents and assistance personnel, gender differences, Mycoplasma-infected and Mycoplasma non-infected patients were monitored. The major symptoms reported were extreme fatigue, non-restorative sleep, concentration-problems, memory problems and muscle and joint pains. There were no changes in the SCL-90 responses that indicated any alteration of psychological distress. Assessment using the MMPI-II revealed a profile typically seen in chronic physical illness and assessment of the Harris-Lingoes scales revealed no elevations in pathogenic scales. Twelve subjects (67%) had a positive Mycoplasma PCR response. Victims of the Bijlmermeer plane crash disaster had increases in symptoms similar to patients with Gulf War Syndrome and CFS and no evidence of somatoform disorder, anxiety or depression. Similar to patients with Gulf War Syndrome and CFS, a deregulation of the immune-competence through a combination of toxic material exposure and psychological stressors associated with increased opportunistic infections may be the most likely etiological hypothesis.
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BACKGROUND: This study examines the care needs of rehabilitating breast cancer survivors and determines what sociodemographic and medical characteristics are associated with these care needs. METHODS: A large-scale cross-sectional study... more
BACKGROUND: This study examines the care needs of rehabilitating breast cancer survivors and determines what sociodemographic and medical characteristics are associated with these care needs. METHODS: A large-scale cross-sectional study (n = 465, response rate = 65%) was conducted among survivors who had ended primary treatment less than 6 months previously. Questionnaires were completed regarding participants' care needs, how these needs were met and the time and manner preferred for receiving information and support. Care needs regarding seven specific rehabilitation topics were assessed separately: (1) physical functioning, (2) psychological functioning, (3) self and body image, (4) sexuality, (5) relationship with partner, (6) relationship with others, and (7) work, return to work and social security. RESULTS: High unmet needs were reported across all topics. The time preferred for receiving information and support across most topics was the period of breast cancer treatmen...
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OBJECTIVE: Physical activity determinants are subject to change when confronted with the diagnosis of 'cancer' and new cancer-related determinants appear. The aim of the present study is to compare the contribution of... more
OBJECTIVE: Physical activity determinants are subject to change when confronted with the diagnosis of 'cancer' and new cancer-related determinants appear. The aim of the present study is to compare the contribution of cancer-related determinants with more general ones in explaining physical activity 3 weeks to 6 months post-treatment. METHODS: A theory-based and validated questionnaire was used to identify physical activity levels (total and domain-specific) and associated determinants among 464 breast cancer survivors (aged 18 to 65 years) 3 weeks to 6 months post-treatment. RESULTS: Descriptive analyses showed higher scores for general determinants in comparison with cancer-related determinants. Nevertheless, regression analyses showed that both general and cancer-related determinants explained total and domain-specific physical activity. Self-efficacy, enjoyment, social support, lack of time and lack of company were important general determinants. The perception of retu...
Research Interests: Psychology, Oncology, Cancer, Quality of life, Physical Activity, and 22 moreSocial Support, Adolescent, Fatigue, Belgium, Self Efficacy, Humans, Survivors, Psycho, Female, Regression Analysis, Young Adult, Exercise, Psycho Oncology, Determinants, Clinical Sciences, Aged, Middle Aged, Questionnaires, Adult, Time Factors, Survivorship, and Motor activity
The transition from breast cancer patient to survivor is associated with many treatment-related and psychosocial factors, which can influence health behaviour and associated needs. First, this study aimed to identify clusters of... more
The transition from breast cancer patient to survivor is associated with many treatment-related and psychosocial factors, which can influence health behaviour and associated needs. First, this study aimed to identify clusters of treatment-related and psychosocial factors among breast cancer survivors. Second, clusters' physical activity levels and care needs for physical activity were evaluated. Breast cancer survivors (n= 440; 52 ± 8 years) (3 weeks to 6 months post treatment) completed self-reports on physical and psychological symptoms; illness representations; social support and coping; physical activity and care needs for physical activity. Analyses identified four clusters: (1) a low distress-active approach group; (2) a low distress-resigned approach group; (3) a high distress-active approach group; and (4) a high distress-emotional approach group. Physical activity levels were higher in the low distress groups than in the high distress-emotional approach group. However, women with low distress and an active approach reported equal care needs for physical activity than women with high distress and an emotional approach. These findings suggest that care needs for physical activity are unrelated to distress and actual physical activity levels. The results emphasise the importance of screening for needs and provide a framework supporting the referral of breast cancer survivors to tailored interventions.
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On-line provision of information during the transition phase after treatment carries great promise in meeting shortcomings in post-treatment care for breast cancer survivors and their partners. The objectives of this study are to describe... more
On-line provision of information during the transition phase after treatment carries great promise in meeting shortcomings in post-treatment care for breast cancer survivors and their partners. The objectives of this study are to describe the development and process evaluation of a tailored informative website and to assess which characteristics of survivors and partners, participating in the feasibility study, are related to visiting the website. The development process included quantitative and qualitative assessments of survivors' and partners' care needs and preferences. Participants' use and evaluation of the website were explored by conducting baseline and post-measurements. During the intervening 10-12 weeks 57 survivors and 28 partners were granted access to the website. Fifty-seven percent (n=21) of survivors who took part in the post-measurement indicated that they had visited the website. Compared to non-visitors (n=16), they were more likely to have a partner and a higher income, reported higher levels of self-esteem and had completed treatment for a longer period of time. Partners who consulted the on-line information (42%, n=8) were younger and reported lower levels of social support compared to partners who did not visit the website (n=11). Visitors generally evaluated the content and lay-out positively, yet some believed the information was incomplete and impersonal. The website reached only about half of survivors and partners, yet was mostly well-received. Besides other ways of providing information and support, a website containing clear-cut and tailored information could be a useful tool in post-treatment care provision.
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ABSTRACT Background: Recent studies highlight the importance of social support in multiple sclerosis (MS). Social support is included in the prognostic risk factors and is believed to correlate statistically significant with an early... more
ABSTRACT Background: Recent studies highlight the importance of social support in multiple sclerosis (MS). Social support is included in the prognostic risk factors and is believed to correlate statistically significant with an early development of chronic disability. Goals: To examine whether and how social support was positively influenced when following a physical exercise program. Method: 75 patients where included in a larger multilevel and longitudinal study examining quality of life issues in MS. Social support was studied before, during and after a structured physical program although the results from the initial screening are present. Statistical analyses will included parametric testing (within design) and determination of how much of the variation between patients is accounted for by the factor(s) identified as significant using SPSS 15.0. Results: Preliminary results are based on the first 25 persons with a mean ages of 45,28 (±8,46) years and a Expanded Disability Status Scale of 4,48 (±1,57) indicating significant restrictions in several functions and assistance can be warranted. Most of them (60%) are still functional although some motor limitations are present. Social support was examined for both the actual transactions and satisfaction between the actual level and the desired level of supportive interactions at baseline. Considering the mean scores, social companionship (mean =11,52 ± 3,07) and daily instrumental support (mean = 7,40 ± 1,96) occurred less than daily social emotional and problem orientated social emotional support (mean = 14,20 ± 2,99; 14,96 ± 2,53) in this population. Considering the mean scores for the satisfaction, the actual number of transactions concurred well with the desired number of transactions for most subscales with the lowest satisfaction for social companionship. Discussion: The pursuit of studying prognostic risk factors is driven by the prospect that appropriate intervention, early in the course of the problem directed at the risk factor may delay chronic disability. By the end of the summer, our research team can present results from three different measurements from the influence of an exercise program on instrumental and functional social support.
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ABSTRACT Background: Recently, a new instrument was developed to measure soical support. It consists of two parts; the Social Support Questionnaire for Transactions (SSQT) and the Social Support Questionnaire for Satisfaction with the... more
ABSTRACT Background: Recently, a new instrument was developed to measure soical support. It consists of two parts; the Social Support Questionnaire for Transactions (SSQT) and the Social Support Questionnaire for Satisfaction with the supportive transactions (SSQS). There are, on the one hand, actual supportive transactions and, on the other hand, the perception of being supported or the satisfaction with the social support provided. Goals of study: To examine the test retest reliability and convergent validity of the SSQT and SSQS in MS. Methods: 75 patients were included in a larger multilevel and longitudinal study examining quality of life issues in MS. During the initial screening using questionnaires, the SSQT and SSQS were administered. Test retest reliability data obtained with the self-report instrument was assessed by having the subjects complete a modified version of the questionnaire at home and returning it within 24 hours. Results: These preliminary results are based on the first 25 included patients with an EDDS of 4,48 (±1,57). Demographical variables are presented elsewhere. The test-retest interclass correlation coefficients (ICCs) of the subscales were <0.75 except for the scores ICCs for subscale problem-oriented social-emotional support (0.67), daily instrumental support (0.65 for transactions and 0.25 for satisfaction) and problem-oriented instrumental support (0.58). Discussion: We concluded that nearly all subscales of this recently developed questionnaire can be presented with sufficient reliability. The imperfect (ie not suggesting a linear correlation: R=1) reliability coeffficient suggests the difference might be caused by a change in health status. More specifically, cognitive disturbances frequently associated with MS and possibly induced by completion of the initial screening. The subscales with ICCs <0.75 are indeed oriented towards daily (possibly increased) instrumental support and problem-oriented support. Moreover, changes could be induces through forced confrontation using the items of this questionnaire.
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Background: Little data exist on the reasons for dropout in consecutive preventive breast-cancer screenings among (Belgian) women. Since drop-out rates appear high, it is important to further investigate why women do not re-attend for... more
Background: Little data exist on the reasons for dropout in consecutive preventive breast-cancer screenings among (Belgian) women. Since drop-out rates appear high, it is important to further investigate why women do not re-attend for subsequent screening in order to lower the drop-out rates. Subsequently, a target-group-based survey, including client satisfaction variables, was performed in the province of Limburg (Belgium). Method: A questionnaire was mailed to 7555 women (age 54 to 70) (response rate=42.09%) who did not re-attend (drop-out group) in a preventive breast cancer screening program. This questionnaire examined demographic and detailed reasons for drop-out including some client satisfaction variabels. Results: Receiving an alternative medical advice from another doctor and problems with the recall letter were the most commonly reported reasons for drop-out. The former indicates the importance of including the medical doctor into the program as women seem to consider th...
Little is known of cancer rehabilitation needs in Europe. EUROCHIP-3 organised a group of experts to propose a list of population-based indicators used for describing cancer rehabilitation across Europe. The aim of this study is to... more
Little is known of cancer rehabilitation needs in Europe. EUROCHIP-3 organised a group of experts to propose a list of population-based indicators used for describing cancer rehabilitation across Europe. The aim of this study is to present and discuss these indicators. A EUROCHIP-3 expert panel reached agreement on two types of indicators. (a) Cancer prevalence indicators. These were proposed as a means of characterising the burden of cancer rehabilitation needs by time from diagnosis and patient health status. These indicators can be estimated from cancer registry data or by collecting data on follow-up and treatments for samples of cases archived in cancer registries. (b) Indicators of rehabilitation success. These include: return to work, quality of life, and satisfaction of specific rehabilitation needs. Studies can be performed to estimate these indicators in individual countries, but to obtain comparable data across European countries it will be necessary to administer a quest...
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Cancer is a major European public health issue and represents the second most important cause of death and morbidity in Europe. Moreover, as a result of constant advances in medicine, medical technology and other sciences, and due to... more
Cancer is a major European public health issue and represents the second most important cause of death and morbidity in Europe. Moreover, as a result of constant advances in medicine, medical technology and other sciences, and due to improvements in economic circumstances, cancer survival rates are increasing in Europe and prevalent cases (i.e. number of subjects who have experienced cancer) represent a growing proportion of the population. In order to tackle cancer efficiently throughout the European Member states, the European Commission launched the Joint Action (JA) 'European Partnership for Action Against Cancer' (EPAAC) facilitated by the Community Health Programme, in September 2009. EPAAC is designed to fill a gap in cooperation, collaboration and shared experiences for countries with similar needs and diverse experience in the area of their national cancer control policies. Activities and studies are tackling the main challenges of cancer control in Europe as a whol...