Response shift after coronary revascularization

Purpose The aims of this study were to investigate (1) the extent to which response shift occurs among patients with coronary artery disease (CAD) after coronary revascularization, (2) whether the assessment of changes in health-related quality of life (HRQoL), controlled for response shift, yield more valid estimates of changes in HRQoL, as indicated by stronger associations with criterion measures of change, than without controlling for response shift, and (3) if occurrences of response shift are related to patient characteristics. Methods Patients with CAD completed the SF-36 and the Seattle Angina Questionnaire (SAQ7) at baseline and 3 months after coronary revascularization. Sociodemographic, clinical and psychosocial variables were measured with the patient version of the New York Heart Association-class, Subjective Significance Questionnaire, Reconstruction of Life Events Questionnaire (RE-LIFE), and HEXACO personality inventory. Oort's Structural Equation Modeling (SEM) approach was used to investigate response shift. Results 191 patient completed questionnaires at baseline and at 3 months after treatment. The SF-36 showed recalibration and reprioritization response shift and the SAQ7 reconceptualization response shift. Controlling for these response shift effects did not result in more valid estimates of change. One significant association was found between reprioritization response shift and complete integration of having CAD into their life story, as indicated by the RE-LIFE. Conclusion Results indicate response shift in HRQoL following coronary revascularization. While we did not find an impact of response shift on the estimates of change, the SEM approach provides a more comprehensive insight into the different types of change in HRQoL following coronary revascularization.Biological, physical and clinical aspects of cancer treatment with ionising radiatio

Labor participation among patients with inflammatory bowel disease.

Background: The aims of the present study are twofold. First, to describe labor participation rates of people with inflammatory bowel disease (IBD) in the Netherlands compared with the total Dutch population and to people with chronic illness in general. Second, to explore differences in labor participation among IBD patients and assess the potential impact of a number of characteristics of IBD patients on labor participation. Methods: Data were obtained from a nationwide survey of individuals with IBD in the Netherlands. In all, 1115 respondents completed the survey. Univariate, bivariate, and multinomial logistic regression analysis were conducted to identify factors predicting the number of hours worked by IBD patients. Results: People with IBD do not participate less often in the labor market compared with the total Dutch population age 15 to 64. However, male patients age 45 to 64 less often have a fulltime job compared with age- and gender-matched reference groups from the general population. People with IBD are more likely to participate in the labor market than people with chronic illness in general. Gender, age, duration of illness, having a stoma or pouch, comorbidity, vitality, pain, and perceived personal control appear to be significant predictors of the number of hours worked. Conclusions: People with IBD in the Netherlands are as often employed as the general population, but among some gender/age categories fewer people work fulltime. Besides sociodemographic and illness characteristics, the perception of personal control over the illness explains differences in the number of hours worked. Strengthening IBD patients' control perceptions deserves attention.(aut. ref.

Diabetes zelf in de hand: ontwikkeling en eerste evaluatie van een educatieve website over diabetes voor mensen met een verstandelijke beperking, hun begeleiders en mantelzorgers

Eerder onderzoek laat zien dat er bij mensen met verstandelijke beperkingen en diabetes, hun begeleiders en mantelzorgers behoefte bestaat aan voorlichtingsmateriaal over leven met diabetes, toegesneden op hun situatie. Daarom ontwikkelden vijf organisaties gezamenlijk een website voor deze drie doelgroepen. In dit artikel laten we zien hoe de website tot stand kwam en beschrijven we het resultaat van een kleine evaluatie. De deelnemers van de bijeenkomsten in het ontwikkeltraject van de website en de twaalf potentiële gebruikers die meededen aan het evaluatieonderzoek waren positief over de website en gaven aan de website te zullen gebruiken. Vooral de ervaringsverhalen en interactieve kennistesten werden interessant gevonden. Er blijft ruimte voor verbetering, zoals een plaats op de website waar mensen hun eigen ervaringen en tips kunnen delen. Geconcludeerd wordt dat deze educatieve website voor mensen met een verstandelijke beperking met diabetes, hun begeleiders en familieleden voldoet aan een behoefte maar dat uitbreiding van de website met een forum of chatfunctie wenselijk is. Ook het effect van de website op het daadwerkelijke zelfmanagement en de ondersteuning moet nog worden onderzocht

Eenheid of verdeeldheid? Burgerschap in een gedifferentieerd voortgezet onderwijssysteem

This paper examines whether there are differences in civic competences between secondary school children on the basis of school type, gender, ethnicity and parents’ education, and whether such differences are smaller in schools that devote greater attention to civic education. Using survey data form students and school principals in fifteen secondary schools in the Netherlands, we examine civic competences relating to ‘democratic behaviour’, ‘socially responsible behaviour’, and ‘dealing with social differences’. Our analyses show that students differ significantly in how they judge their own competences in these domains. Furthermore, differences in socially responsible behaviour between students of different levels of parental education are smaller in schools that pay much attention to civic education. No evidence for mitigating effects of a school’s attention to civic education emerged for either democratic behaviour or responsible behaviour

Narrative meaning making and integration: towards a better understanding of the way falling ill influences quality of life

Contains fulltext : 176716pub.pdf (publisher's version ) (Open Access)Falling seriously ill is often experienced as a life event that causes conflict with people’s personal goals and expectations in life and evokes existential questions. This article presents a new humanities approach to the way people make meaning of such events and how this influences their quality of life. Incorporating theories on contingency, narrative identity, and quality of life, we developed a theoretical model entailing the concepts life event, worldview, ultimate life goals, experience of contingency, narrative meaning making, narrative integration, and quality of life. We formulate testable hypotheses and describe the self-report questionnaire that was developed based on the model.26 september 201717 p

Reconstructing disruptive life events using the RE-LIFE questionnaire: further validation of the ‘Narrative meaning making of life events’ model using multiple mediation analysis

Contains fulltext : 208302pub.pdf (publisher's version ) (Open Access

The dynamics in Health-Related Quality of Life of patients with Stable Coronary Artery Disease were revealed: a network analysis

Contains fulltext : 200246pub.pdf (publisher's version ) (Open Access)Objective: Health-related quality of life (HRQoL) is a dynamic construct. Experience sampling methods (ESM) are becoming increasingly popular to capture within-person fluctuations in HRQoL. An emerging approach to analyze such momentary data is network analysis. Our aim was to explore the use of network analysis for investigating the dynamics within individual’s HRQoL. Study Design and Setting: We analyzed ESM data of 30 patients with stable coronary artery disease (CAD). Patients completed eight HRQoL items representing four scales (i.e., positive mood, negative mood, CAD symptoms, and physical state) at nine times a day for seven consecutive days. Network analysis was used to analyze the data at group level to estimate the average HRQoL dynamics and at patient level to estimate HRQoL dynamics of individual patients. Results: Group-level analysis showed that, on average, feeling ‘‘tired’’ and feeling ‘‘anxious’’ are the most central items in patients’ HRQoL. Patient-level analysis revealed differences in patients’ network structures, indicating within-person differences in HRQoL dynamics. Conclusion: This study is one of the first to apply network analysis to momentary HRQoL data. To the extent that network models are meaningful representations of HRQoL dynamics, they may help deepening our insight into experienced HRQoL and provide targets for personalized treatment.08 december 201

Ecological momentary assessment versus retrospective assessment for measuring change in health-related quality of life following cardiac intervention

Contains fulltext : 231718pub.pdf (publisher's version ) (Open Access)In comparison to male patients with coronary artery disease, female patients suffer from more comorbidities, experience symptoms of coronary artery disease differently and report poorer health-related quality of life (HRQoL) after coronary revascularization. However, there is limited data on the impact of comorbidity burden on the recovery in HRQoL in female and male patients. We investigated the impact of comorbidity burden on the change in HRQoL following coronary revascularization in female patients versus male patients. 230 patients (60 female) with coronary artery disease were assessed before, and two weeks, three months and six months after coronary revascularization. Disease-specific HRQoL was measured with the Short-Form Seattle Angina Questionnaire. Physical and mental health was measured with the Short-Form Health Survey. Comorbidity burden was assessed by the total number of identified comorbidity conditions and by the Charlson comorbidity score. Linear mixed models were used to estimate the effects of time, gender and comorbidity burden on HRQoL. Whereas HRQoL improved after coronary revascularization in all patients, female patients reported poorer physical health and disease-specific HRQoL and their physical health improved more slowly than male patients. A higher comorbidity burden was related with poorer physical health and disease-specific HRQoL in male patients, but not in female patients. A higher comorbidity burden was associated with slower improvement in HRQoL for both female and male patients. Female patients reported poorer HRQoL and their physical health improved more slowly after coronary revascularization, irrespective of comorbidity burden. Higher comorbidity burden was associated with poorer physical health and disease-specific HRQoL in male patients only. Our results indicate that female and male patients recover differently after coronary revascularization. These findings highlight the importance of comorbidity- and gender-specific approaches for evaluating coronary artery disease and coronary revascularization procedures.27 augustus 202

Ecological momentary assessment versus retrospective assessment for measuring change in health-related quality of life following cardiac intervention

In comparison to male patients with coronary artery disease, female patients suffer from more comorbidities, experience symptoms of coronary artery disease differently and report poorer health-related quality of life (HRQoL) after coronary revascularization. However, there is limited data on the impact of comorbidity burden on the recovery in HRQoL in female and male patients. We investigated the impact of comorbidity burden on the change in HRQoL following coronary revascularization in female patients versus male patients. 230 patients (60 female) with coronary artery disease were assessed before, and two weeks, three months and six months after coronary revascularization. Disease-specific HRQoL was measured with the Short-Form Seattle Angina Questionnaire. Physical and mental health was measured with the Short-Form Health Survey. Comorbidity burden was assessed by the total number of identified comorbidity conditions and by the Charlson comorbidity score. Linear mixed models were used to estimate the effects of time, gender and comorbidity burden on HRQoL. Whereas HRQoL improved after coronary revascularization in all patients, female patients reported poorer physical health and disease-specific HRQoL and their physical health improved more slowly than male patients. A higher comorbidity burden was related with poorer physical health and disease-specific HRQoL in male patients, but not in female patients. A higher comorbidity burden was associated with slower improvement in HRQoL for both female and male patients. Female patients reported poorer HRQoL and their physical health improved more slowly after coronary revascularization, irrespective of comorbidity burden. Higher comorbidity burden was associated with poorer physical health and disease-specific HRQoL in male patients only. Our results indicate that female and male patients recover differently after coronary revascularization. These findings highlight the importance of comorbidity- and gender-specific approaches for evaluating coronary artery disease and coronary revascularization procedures