Dutch rheumatologists and oncologists are positive about health-related Internet us by their patients

Background: An increasing number of patients are using the Internet to search for health-related information. Objectives: To explore the experiences and attitudes of rheumatologists and oncologists with regard to health-related Internet use by their patients. In addition, we explored how often physicians referred their patients to health-related Internet sites. Methods: We sent a questionnaire to all Dutch rheumatologists and oncologists. The questionnaire included questions on demographics, experiences with health-related Internet use by patients, referral behavior and attitudes about consequences of health-related Internet use by patients for patients themselves, the physician-patient relationship and health care. The response rate was 46% (N=238). Of these respondents 134 were in practice as a rheumatologist and 104 were in practice as an oncologist. Results: Almost all physicians encountered that patients raised information from the Internet during a consultation. However, physicians were not confronted with health-related Internet use by their patients on a daily basis. Physicians had a moderately positive attitude towards the consequences of health-related Internet use. The physicians indicated that patients are often better informed about their illness (54%) and often better informed about treatment options (51%) as a result of Internet use. According to the physicians, a negative consequence of health-related Internet use was that patients are more often unnecessarily concerned. Physicians felt that health-related Internet use by patients could sometimes (48%) or often (30%) lead to patients being more capable in participating in the decision making process concerning their treatment. Although 43% of physicians indicated that health related Internet use did almost never or usually not lead to better treatment decisions, many physicians (41%) indicated that sometimes health-related Internet use can lead to better treatment decisions. Most of the physicians indicated that health-related Internet use is usually not (46%) or almost never (23%) undermining the physicians' authority. The physicians indicated that unnecessary diagnostics and unnecessary treatments were often not provided as a result of Internet use by patients. Physicians indicated that the duration of a medical consultation sometimes (39%) or often (36%) increases because of health-related Internet use by patients. Oncologists were significantly less positive about the consequences of health-related Internet use for the physician-patient relationship and the health-care than rheumatologists. Most of the physicians have never (32%) or only sometimes (42%) referred a patient to a health-related Internet site. Most physicians (53%) found it hard to stay up to date about reliable Internet sites for patients. Conclusion: Physicians are moderately positive about health-related Internet use of their patients, but they only seldom refer their patients to health-related Internet sites. Possibly, offering an up-to-date list with accredited websites for patients would be of help for and stimulate physicians to refer their patients

特集 開学当時の思い出 III.大学予科の思い出と当時の食糧事情

Contains fulltext : 171282.pdf (Publisher’s version ) (Open Access)PURPOSE: The purpose of this study was to investigate the feasibility of an online self-care education program supporting early rehabilitation of patients after total laryngectomy (TLPs) and factors associated with satisfaction. METHODS: Health care professionals (HCPs) were invited to participate and to recruit TLPs. TLPs were informed on the self-care education program "In Tune without Cords" (ITwC) after which they gained access. A study specific survey was used (at baseline T0 and postintervention T1) on TLPs' uptake. Usage, satisfaction (general impression, willingness to use, user-friendliness, satisfaction with self-care advice and strategies, Net Promoter Score (NPS)), sociodemographic, and clinical factors were analyzed. RESULTS: HCPs of 6 out of 9 centers (67 % uptake rate) agreed to participate and recruited TLPs. In total, 55 of 75 TLPs returned informed consent and the baseline T0 survey and were provided access to ITwC (73 % uptake rate). Thirty-eight of these 55 TLPs used ITwC and completed the T1 survey (69 % usage rate). Most (66 %) TLPs were satisfied (i.e., score >/=7 (scale 1-10) on 4 survey items) with the self-care education program (mean score 7.2, SD 1.1). NPS was positive (+5). Satisfaction with the self-care education program was significantly associated with (higher) educational level and health literacy skills (P = .004, P = .038, respectively). No significant association was found with gender, age, marital status, employment status, Internet use, Internet literacy, treatment modality, time since total laryngectomy, and quality of life. CONCLUSION: The online self-care education program ITwC supporting early rehabilitation was feasible in clinical practice. In general, TLPs were satisfied with the program

Uptake and usage of an online prostate cancer treatment decision aid in Dutch clinical practice: A quantitative analysis from the Prostate Cancer Patient Centered Care trial

Contains fulltext : 207935.pdf (publisher's version ) (Open Access)Implementation of patient's decision aids in routine clinical care is generally low. This study evaluated uptake and usage of a novel Dutch web-based prostate cancer treatment decision aid within the Prostate Cancer Patient Centered Care trial. From an estimated total patient sample of 1006 patients, 351 received a decision aid (35% implementation rate; hospital ranges 16%-84%). After receipt of the decision aid, most patients accessed the decision aid, utilized most functions, although not completely, and discussed the decision aid summary in a subsequent consultation with their care provider. Including nurses for dissemination of decision aids seemed to positively affect decision aid uptake. Once received, patients seemed able to use the decision aid and engage in shared decision-making as intended; however, decision aid uptake and complete usage of all decision aid components should be further improved. Prior to the diagnosis consultation, handing out of the decision aid should be prepared.13 p

Cancer patients’ experiences with and perceived outcomes of yoga: results from focus groups

Purpose Yoga is a “mind–body” exercise, a combination of physical poses with breathing and meditation, and may have beneficial effects on physical and psychosocial symptoms. We aimed to explore cancer patients’ motives for practicing yoga, experiences of practicing yoga, and perceived physical and psychosocial outcomes. Methods Participants (n = 45) following yoga classes for cancer patients were asked to participate in focus group interviews, of whom 29 participated. The focus groups (n = 5) were audio taped with prior consent and transcribed verbatim. Data were analyzed by two coders and independently coded into key issues and themes. Results Mean age of the participants was 53.8 (SD 10.8) years, of whom 25 were women, and 18 were diagnosed with breast cancer. Motives for participation in yoga were relaxation, the will to be physically active, the wish to pay more attention to one’s body, coping with psychosocial symptoms, contributing to their cancer rehabilitation process, and combing physical and mental processes. Main physical and psychosocial experiences of yoga mentioned by patients were regaining body awareness, raising attention to the inner self, learning how to relax, enjoyment, and finding recognition and understanding. Increased physical fitness and function, mental strength and resilience, increased coping, being more relaxed, and happiness were frequently mentioned experiences of patients. Conclusions Patients with different types of cancer perceived several benefits on physical and psychosocial outcomes by practicing yoga. Therefore, yoga can be a valuable form of supportive care for cancer patients