Abstract Introduction: Parkinson’s Disease (PD) is a progressive neurodegenerative disorder which has a big impact on patients’ lives. During diagnostic consultations clinicians inform patients...Show moreAbstract Introduction: Parkinson’s Disease (PD) is a progressive neurodegenerative disorder which has a big impact on patients’ lives. During diagnostic consultations clinicians inform patients regarding the PD diagnosis and the treatment patients will receive. PD patients report dissatisfaction with the diagnostic consultations, which could be due to a lack of involvement in medical decision-making (MDM). More information about the topics of MDM, about the level of trust in the patients’ clinician and more patient involvement in MDM could therefore improve patient satisfaction. Research on patient involvement in MDM and trust in their clinician was still scarce. However, we think that patient satisfaction could be higher if patient involvement in MDM and trust in their clinician were improved. The first step in researching this was to investigate the MDM topics during diagnostic consultations for PD patients. Specifically, this study aimed to assess the level of patient involvement in MDM during diagnostic consultations and the factors affecting patient involvement. Finally, this study aimed to examine if patients who were more involved in MDM, had higher trust in their clinician. Gaining insight on these topics could empower them to implement more patient involvement and might thus lead to higher satisfaction and patients’ trust in their clinician. Methods: This study was a part of the DiaMove-project which had a prospective observational mixed-methods longitudinal design. Participants (N=26) completed questionnaires regarding characteristics before diagnostic consultations and reported trust in their clinicians (TiOS-sf) afterwards. The first and second diagnostic consultations were video-recorded. Researchers observationally coded topics of medical decisions and measured patient involvement regarding PD medication using the OPTION-12. Statistical analyses consisted of (multiple) regression analyses. Results: Most commonly observed MDM during diagnostic consultations regarding PD concerned whether or not to start PD medication and follow-up appointments. Patients mean involvement in MDM was low (M=14.11; 2.08 – 50.00). The level of patient involvement was higher for women (Cohen’sf 2=.24; p=.02). Age (p=.30) and educational level (p=.66) did not predict patient involvement. Moreover, the mean patient involvement was 4.18 on a scale from 1 to 5, and did not predict patients’ trust in clinicians (p=.90). Conclusion: Clinicians discuss decisions regarding PD medication and follow-up appointments were most frequently discussed during diagnostic consultations. The results suggested that patients’ mean involvement is low in medical decisions regarding PD medication. However, women are more involved. The results of this study should be interpreted cautiously because of a small sample size. It is recommended to repeat this study with a larger sample size. For clinical practice clinicians are advised to involve their patients more in the medical decision-making process.Show less
Abstract Introduction: Parkinson’s Disease (PD) is a progressive neurodegenerative disorder which has a big impact on patients’ lives. During diagnostic consultations clinicians inform patients...Show moreAbstract Introduction: Parkinson’s Disease (PD) is a progressive neurodegenerative disorder which has a big impact on patients’ lives. During diagnostic consultations clinicians inform patients regarding the PD diagnosis and the treatment patients will receive. PD patients report dissatisfaction with the diagnostic consultations, which could be due to a lack of involvement in medical decision-making (MDM). More information about the topics of MDM, about the level of trust in the patients’ clinician and more patient involvement in MDM could therefore improve patient satisfaction. Research on patient involvement in MDM and trust in their clinician was still scarce. However, we think that patient satisfaction could be higher if patient involvement in MDM and trust in their clinician were improved. The first step in researching this was to investigate the MDM topics during diagnostic consultations for PD patients. Specifically, this study aimed to assess the level of patient involvement in MDM during diagnostic consultations and the factors affecting patient involvement. Finally, this study aimed to examine if patients who were more involved in MDM, had higher trust in their clinician. Gaining insight on these topics could empower them to implement more patient involvement and might thus lead to higher satisfaction and patients’ trust in their clinician. Methods: This study was a part of the DiaMove-project which had a prospective observational mixed-methods longitudinal design. Participants (N=26) completed questionnaires regarding characteristics before diagnostic consultations and reported trust in their clinicians (TiOS-sf) afterwards. The first and second diagnostic consultations were video-recorded. Researchers observationally coded topics of medical decisions and measured patient involvement regarding PD medication using the OPTION-12. Statistical analyses consisted of (multiple) regression analyses. Results: Most commonly observed MDM during diagnostic consultations regarding PD concerned whether or not to start PD medication and follow-up appointments. Patients mean involvement in MDM was low (M=14.11; 2.08 – 50.00). The level of patient involvement was higher for women (Cohen’sf 2=.24; p=.02). Age (p=.30) and educational level (p=.66) did not predict patient involvement. Moreover, the mean patient involvement was 4.18 on a scale from 1 to 5, and did not predict patients’ trust in clinicians (p=.90). Conclusion: Clinicians discuss decisions regarding PD medication and follow-up appointments were most frequently discussed during diagnostic consultations. The results suggested that patients’ mean involvement is low in medical decisions regarding PD medication. However, women are more involved. The results of this study should be interpreted cautiously because of a small sample size. It is recommended to repeat this study with a larger sample size. For clinical practice clinicians are advised to involve their patients more in the medical decision-making process.Show less
Background Worldwide, problem drinking is a leading risk factor for disease burden and mortality. To reduce this burden, effective interventions are required. Mobile phone-based alcohol...Show moreBackground Worldwide, problem drinking is a leading risk factor for disease burden and mortality. To reduce this burden, effective interventions are required. Mobile phone-based alcohol interventions show promise due to their ease of use and scalability. However, there is limited knowledge regarding their overall effectiveness. As it is a rapidly developing field, this meta-analysis captures the current state of evidence. Mobile phone-based alcohol interventions are expected to be more effective than control groups with minimal or no intervention. Methods A systematic literature search and meta-analysis were conducted following PRISMA guidelines. In April 2022 the databases PubMed, EMBASE, PsycINFO, CINAHL, and Web of Science were searched to identify eligible studies. The search focused on publications between 2010 and 2022, without language restrictions. Randomised controlled trials comparing mobile phone-based interventions with minimal or no intervention control conditions were included. Studies with interventions tailored to students and pregnant women were excluded. Outcome data were extracted and the pooled effect size was calculated with a random effects model. Risk of bias was assessed using the revised Cochrane Risk of Bias tool and quality of evidence with the Grading of Recommendations Assessment, Development and Evaluation approach. Results Five studies with 1672 participants were included and revealed a combined small effect size (Hedges’ g = -0.28, 95% CI [-0.76, 0.21]), which was insignificant (p = .19). Intervention duration and mode of delivery did not have a significant moderating effect on the outcome. Between-study heterogeneity was high and influence analyses revealed one study potentially overly contributing to the heterogeneity. There was no evidence of publication bias. Risk of bias was considered to be high for each study and the overall quality of evidence was judged to be low. Conclusion The current study found no support for the efficacy of mobile phone-based alcohol intervention compared to minimal or no intervention control groups to reduce adult problem drinking. These results should be interpreted cautiously due to the small number of studies and concerns regarding the quality of evidence. Future researchers should consider using a standard set of outcome measures to make findings in this area more comparable.Show less
Background: The coronavirus pandemic had a direct impact on mental health, influencing well-being and the choice of coping behaviors used to face this unique life adversity. Adverse childhood...Show moreBackground: The coronavirus pandemic had a direct impact on mental health, influencing well-being and the choice of coping behaviors used to face this unique life adversity. Adverse childhood experiences have been linked to specific choices of coping behaviors which could lead to poorer health outcomes, therefore worse well-being. Aim: Investigate whether adverse childhood experiences predict pandemic coping behaviors and if adverse childhood experiences moderate the relationship between pandemic coping behaviors and well-being during the COVID-19 pandemic. Methodology: This study was part of the CONNECT study within the Netherlands, which is part of a larger international longitudinal collaboration from eleven countries in Europe (ADJUST study). The participants were recruited through social media platforms from July to November 2020. Sociodemographic data were gathered, along with the following questionnaires: Adverse Childhood Experiences questionnaire (ACE) to measure adverse childhood experiences, Pandemic Coping Scale (PCS) to measure pandemic coping behaviors, and WHO-5 Well-being Index (WHO-5) to measure well-being. Descriptive analysis as well as a MANOVA and moderation analyses were performed. Results: The responses of 2,022 individuals were analyzed. The mean age of the participants was 36, females (70.4%), males (29.1%), and others (0.5%). The mean for adverse childhood experiences was 1.3 and most of the population was considered low risk (86.9%). The mean score for well-being was 13.1 and 22.4 for PCS scores, which indicate high scores in well-being and coping behaviors. The MANOVA showed a significant model equation (p = .040) and non-significant individual relationships between ACEs and each pandemic coping style (preventative actions, p = .73; healthy lifestyle, p = .929; daily structure, p = .784; joyful activities, p = .162). The moderation effect of ACE in the relationship between coping and well-being was not significant (p = .150). Conclusions: This study shows the relation between well-being, pandemic coping behaviors, and adverse childhood experiences during the current coronavirus pandemic, as well as an insight into the Dutch population's experience of the first wave of the coronavirus pandemic. Further research is advised.Show less
