Does mammographic screening and a negative result affect attitudes towards future breast screening?

OBJECTIVES:To investigate the impact of an experience of a benign mammographic result on intention to seek medical help immediately in the case of breast abnormalities, and on intentions and thoughts about future participation in screening. SETTING:The Dutch Breast Cancer Screening Programme for women aged 50¿69. METHODS:Subjects were women who were invited for an initial breast examination: 223 women filled out a questionnaire about 10 days before and about 6 weeks after their initial breast examination. To be able to control for possible test effects, another group of 293 women filled out a questionnaire only after mammography. Changes in thoughts and intentions were examined. RESULTS:Most women were very satisfied with the course of their initial breast examination, although pain or discomfort was often mentioned. No clues to suggest false reassurance were found: more than 99% of the women would consider the possibility of breast cancer if they felt a lump in one of their breasts. In such a situation, most women intended to seek medical help within a week. These variables were not influenced by the experience of mammography with a benign result. In general, women were very positive about (repeat) participation, both before and after screening. After screening, the average woman perceived fewer costs in participating, and perceived her own ability to engage in future screening as higher. However, the experience of pain and anxiety during the initial screening did lead to reverse effects. Women who were less satisfied about their treatment by the staff were more likely to change their intentions to reparticipate in a negative way. CONCLUSIONS:As, in general, women became more positive about regular participation after they had attended breast cancer screening, efforts to improve first round attendance must be continued. At the same time, the screening organisations must continue to prioritise the high level of client friendliness throughout the screening. No evidence for detrimental effects of screening through false reassurance among participants was found

Measuring Digital Health Literacy, Why and how?

Digital health literacy or eHealth Literacy refers to a person’s ability to search, select, appraise and apply online health information or appropriately use digital health applications. In this presentation I will address the issue of measurement of these skills. First, we will explore why it is important to measure digital health literacy and discuss the different aims of measuring. Second, we will address some of the currently available instruments, including the oldest and most used instrument, the eHealth Literacy Scale or EHEALS Norman & Skinner, 2006 and some more recent instruments, including the eHealth Literacy Questionnaire, eHLQ Kayser et al. 2018 and the Digital Health Literacy Instrument, DHLI. Van der Vaart & Drossaert, 2017. Of each instrument, I will briefly discuss its underlying theory, some empirical findings, and its strengths and weaknesses. I will conclude with discussing some general challenges in measuring digital health literacy and directions for future research

Self-Compassion as a Resource of Resilience

From risk to resilience and from mental illness only to including mental well-being, a paradigm shift occurs within the field of clinical psychology. Resilience, consisting of recovery as well as sustainability and growth processes, pertains to the successful (and common) adaptation to adversity. This includes a return to baseline functioning or a new emotional equilibrium, as well as maintaining approach motivations toward personal values and goals. There is growing evidence that self-compassion is an inner resource that promotes resilience. Self-compassion aspects of mindfulness, self-kindness, and common humanity facilitate both short-term and long-term adaptation processes. Using examples of going through war (veterans) and going through cancer, this chapter illustrates how self-compassion can contribute to decreased mental distress (including anxiety and loneliness) and increased mental well-being (including emotional stability and self-care behaviors). Compassion-based interventions, both face-to-face and in online format, can contribute to facilitating resilience in the face of adversity. Future research should further investigate the different ways in which self-compassion can promote resilience, taking into account both mental distress and mental well-being aspects of mental health

The science-media interaction in biomedical research in the Netherlands. Opinions of scientists and journalists on the science-media relationship

Scientists’ participation in science communication and public engagement activities is considered important and a duty. However, in particular, the science-media relationship has not been studied frequently. In this paper, we present findings from interviews with both scientists and journalists which were guided by the Theory of Planned Behavior. Results show that different behavioural, normative and control beliefs underlie scientists’ and journalists’ participation in science-media interactions. Both groups are positive about science-media interactions, but scientists perceive various disadvantages in this relationship while journalists perceive mainly practical barriers. Enhancing mutual understanding and further research is suggested

Shared decision-making in palliative cancer care:a life span perspective

Background: Due to complex treatment decisions, shared decision-making is advocated for in elderly cancer patients and in palliative cancer care. However, the process of (shared) decision-making is not comprehensively understood in these groups. Studies suggest age-based differences in patients’ level of preferences and actual involvement. Methods: Patients with metastatic cancers (n = 77) were included in three age groups: ‘middle aged’ (40-64 years), ‘young elderly-’ (65-74 years) and ‘old elderly’ (≥ 75 years). A cross-sectional questionnaire assessed patients’ preferences (CPS), perceived involvement (PICS), level of information (decisional conflict scale) and self-efficacy in patient-physician interaction (PEPPI), health-related quality of life (EORTC QLQ-C30), loneliness and temporal perspective (TFS) as potential correlates. Findings: Χ2 testing revealed that preferences, perceived participation and degrees of concordance do not differ between age groups. A majority of patients preferred and perceived to be involved in decision-making. Nearly 20% of patients was less involved than preferred. Age related factors were not related to perceived and preferred decision-making, although ‘old elderly’ patients were less encouraged by their oncologist to talk about worries. Shared decision-making was more often perceived by women than men and was associated with higher levels of self-efficacy in communication with oncologists. Discussion: Age-related differences with regard to decision making preferences and perceived participation seemed to be cancelled out in palliative cancer care, probably due to near-to-death perception. If clinical practice aims to achieve higher concordance levels, patients’ preferences for involvement should be explicitly discussed. Increased attention to (older) patients’ psycho-social needs is suggested

Patient participation in decision making about Disease Modifying Anti-Rheumatic Drugs:perceived and preferred roles of patients

Purpose: This study explores what role patients with rheumatic diseases perceive and prefer to have in decisions about Disease-Modifying Anti-Rheumatic Drugs (DMARDs) and what the concordance between preferred and perceived role in these decisions is. Method: Patients (n = 519) diagnosed with Rheumatoid Arthritis, Arthritis Psoriatica or Ankylosis Spondylitis from 2 hospitals in the Netherlands filled out a questionnaire. Questions included perceived and preferred role in medical decision making in general, and in 4 specific decision-categories: starting to use traditional DMARDs, starting to inject a DMARD, starting to use biological DMARDs and decrease or stop using DMARDs. Result: Most respondents perceived that, in current practice, treatment decisions in general were made by the doctor (43%) or by the doctor and patient together (55%). However, the perceived roles varied per decision category: e.g., most patients (72%) felt that the decision to start using a traditional DMARD was made by the doctor, whereas the decision to decrease or stop using DMARD’s was more often perceived as being made by the patients themselves (24%) or by doctor and patient together (38%). The preferred roles were, contrary to the perceived roles, consistent across the decision-categories. Most respondents (59%-63%) preferred to share decisions with their doctor. By using a paired sample t test the concordance between the perceived and preferred role was evaluated. Table 1 shows that there was a significant difference in 4 of 5 decision categories. Only the decision to decrease or stop using DMARDs had no significant difference between perceived and preferred role. For a considerable group, the perceived and preferred participation for decision making in general matched (61%); about one third (29%) perceived less participation than preferred and a minority perceived more participation than preferred. Again, the concordance varied across the decision categories. Especially for the decision to start with a traditional DMARD, many respondents had experienced less participation than they preferred (54%). Conclusion: Although patients seem consistent in their preference for participation in various DMARD decisions, the amount of perceived participation varied across the different decisions. Patients should especially be more involved in decisions about starting to use a traditional DMARD. Patient Decision aids might be helpful tools to increase patient participation

How Demanding Is Volunteer Work at a Crisis Line?:An Assessment of Work- and Organization-Related Demands and the Relation With Distress and Intention to Leave

Background: Crisis line services, run by volunteers, offer a listening ear 24/7 to people who cannot or do not want to use professional help. Although previous studies have identified various potential stressors crisis line volunteers face, as yet a comprehensive assessment is lacking with regards to the frequency and perceived stressfulness of work- and organization-related demands, and their relationship with distress and a volunteer's intention to leave. Objective: To identify the frequency and impact of particular stressful situations (demands). In addition, to examine the extent to which these demands are associated with volunteers' demographics, distress and intention to leave the crisis line service. Method: In a cross-sectional study among 543 volunteers of a Dutch crisis line service the participants filled out a questionnaire about their experience of a large number of work- and organization-related demands and their perceived stressfulness. To calculate the impact of demands, the occurrence and stressfulness were multiplied. In addition, work-related distress, intention to leave the crisis line service as well as a number of demographics and work-related characteristics were assessed. Results: Work-related demands with the highest impact on volunteers were calls from people with psychiatric problems and suicidal intentions. “Having no time for a break” was the organization-related demand with the highest impact on volunteers. Eighteen percentage of the volunteers scored moderate or high on distress and 4% had the intention to leave the crisis line service within 1 year. Most work- and organization-related demands were positively associated with volunteers' distress and intention to leave the organization. Being older, being male and spending more hours per week volunteering were significantly, positively correlated with work-related demands. The total explained variance for distress was 16% and for intention to leave 13%. Conclusion: Although most crisis line volunteers experienced low impact from work- and organization-related demands, these demands were significantly related to experienced distress and the intention to leave crisis line service. For volunteers with moderate to high distress it can be useful to implement interventions aimed at increasing personal resources to help them deal with the challenges of the work at the crisis line