This quantitative observational study is a sub-project of a larger prospective cohort study conducted at the Headache Center of Leiden University Medical Center about the use of an E-diary in the...Show moreThis quantitative observational study is a sub-project of a larger prospective cohort study conducted at the Headache Center of Leiden University Medical Center about the use of an E-diary in the clinical headache practice for migraine patients. The first objective was to evaluate the psychometric properties of the E-diary to assess migraine characteristics, as the recent development of remote testing makes it fundamental to validate novel E-health instruments. Moreover, migraine has been associated with depression and anxiety. Previous studies found that they predict an increase in migraine frequency years later. The second objective was to examine whether depression and anxiety symptom severity are associated with an increase in migraine frequency three months later. Migraine patients fill in the headache E-diary on a smartphone application, which keeps track of headache attacks daily. It included thirteen items about migraine symptoms, aura characteristics, headache duration and triptan use. Psychometric properties were assessed by conducting an item response theory analysis (n = 1417). Depression and anxiety symptom severity were measured with the Hospital Anxiety and Depression Scale. A change in migraine frequency was defined as the difference in migraine days between the first and third month and was measured with the headache E-diary. Linear regressions were performed to test whether the depression and anxiety symptoms were associated with an increase in migraine frequency (n = 725). Twelve items had moderate to very high discrimination values and nine had sequential ordered and positive thresholds. The items properly differentiate migrainous headaches from non-migrainous headaches. The aura, aura duration and unilateral location items were the weakest items. Depression was not associated with a change in migraine frequency (F(1, 723) = 0.32, β = 0.02, p = .573, 95% CI [-0.06, 0.11]), and neither was anxiety (F(1, 723) = 1.07, β = -0.05, p = .301, 95% CI [-0.13, 0.04]). In conclusion, the headache E-diary measures migraine risk accurately and the findings of this study contribute to the validity of the E-diary. It could be that three months is too little time to show the relationship between depression, anxiety, and a change in migraine frequency.Show less
Background: Quality of life (QoL) is an important aspect of disease management in patients with dementia. Yet, little is known about this from a patient’s perspective. The aim of this study is to...Show moreBackground: Quality of life (QoL) is an important aspect of disease management in patients with dementia. Yet, little is known about this from a patient’s perspective. The aim of this study is to gain insight in the QoL and instrumental activities of daily living (IADL) in patients with (early onset) dementia and to examine the possible relationships with openness to discuss concerns (ODC), perceived social support (PSS) and problem-focused coping. The main hypothesis tested if more ODC, PSS and a problem-focused coping strategy were related to higher QoL and IADL. Methods: We studied patients visiting the Amsterdam Alzheimer center for a screening-day, who consented to research in the ADC cohort. Of 206 patients visiting the clinic, 162 patients (35-82 years, M = 63.59, 63,6% male) completed an 88-item self-reported questionnaire. Patients were categorized by their cognitive diagnosis (SCD = 42 , AD = 48, other dementia = 33, psychiatric disorder = 20 or other neurological disorder = 19). Correlations and multiple linear regressions were performed to assess the relationships between QoL, IADL, and the social factors. In addition, we performed a linear regression to track down group differences. Tests with a p < .05 after correction for multiple testing using a False Discovery Rate (FDR), were considered significant. Results: The distribution of the QoL scores was widespread (range 0-96) with a low median (50). Correlations showed that both PSS (r = .41, p = 5.5×10-6), ODC (r = .17, p = .02) and problem-focused coping (r = .19, p =.02) correlated with higher QoL scores. For IADL (median = 15.3) this was, only true for the ODC (r = .22, p = .01). There were no differences found between patient groups. Conclusion: This study indicates that PSS, ODC and problem focused coping are related to higher QoL in patients with (early onset) dementia. There were no group differences, but the average QoL score was lower than expected. Improving patients’ psychosocial factors has the potential to optimize QoL in patients visiting a tertiary memory clinic.Show less
Background. Multiple sclerosis (MS) is a degenerative disease affecting the central nervous system. Symptoms include fatigue, worsening mobility, and cognitive impairment. Unemployment is common in...Show moreBackground. Multiple sclerosis (MS) is a degenerative disease affecting the central nervous system. Symptoms include fatigue, worsening mobility, and cognitive impairment. Unemployment is common in the MS-community. Within 10 years of disease onset 50-80% of MS-patients will be unemployed. Absenteeism often precedes unemployment. Work absenteeism has been associated with several physical and psychological factors in MS, such as fatigue, and use of maladaptive coping styles. Our aim is to investigate both fatigue and maladaptive coping as possible predictors for work absenteeism. To our knowledge coping and fatigue have not been investigated together with respect to work absenteeism in MS-patients. It is important to study absenteeism to prevent future unemployment as much as possible. Method. We investigated 269 employed MS-patients (age 21-63, Mage = 42.09, SDage = 9.39, 77.3% female) of which 47 had been absent within the last seven days. Participants completed questionnaires regarding fatigue (checklist for individual strength), coping style (coping inventory for stressful situations), and work absenteeism. We conducted three logistic regression analyses in which absenteeism was the dependent variable. Fatigue was investigated with subjective fatigue, motivation, concentration, and physical activity as predictors. Coping style was investigated with task-oriented, emotion-oriented, and avoidant coping as predictors. The last analysis investigated both fatigue and coping as predictors for absenteeism with all previous predictors mentioned. Results. A model in which multidimensional aspects of fatigue predict absenteeism was significant (X 2 (4) = 30.46, p < .001), fatigue, concentration, and physical activity were significant predictors of absenteeism (Bfatigue = 0.04, p = .036; Bconcentration = 0.07, p = .011, Bphysical_activity = -0.03, p = .032 respectively). A model in which coping style predicts work absenteeism was non-significant (X 2 (3) = 5.88, p = .118). The model in which both fatigue and coping were investigated was significant (X 2 (7) = 30.80, p < .001), however this model did not yield any additional information. Conclusion. Fatigue, concentration, and physical activity predict work absenteeism for MS-patients. Possible interventions might be CBT or motivational interviewing, both these interventions can be used to minimize work absenteeism.Show less
