Introduction: Parkinson’s Disease (PD) is a progressive neurological disorder that severely affects patients’ lives. How patients cope with the stress of receiving this diagnosis is influenced by...Show moreIntroduction: Parkinson’s Disease (PD) is a progressive neurological disorder that severely affects patients’ lives. How patients cope with the stress of receiving this diagnosis is influenced by information-seeking coping style, which can be classified on two dimensions: monitoring (seeking information) and blunting (avoiding information). Patients’ level of monitoring and blunting may affect their perception of amount of information. Clinicians may not tailor the amount of information to the individual needs of patients, negatively impacting their recall. This study hypothesized that the amount of provided information by clinicians is equal for patients who score high on monitoring and patients who score high on blunting. Additionally, this study hypothesized that patients with high monitoring scores would report receiving too little information, and that patients with high blunting scores would report receiving too much information. Method: This study employed a prospective observational longitudinal design as part of the DiaMove Project. The sample consisted of newly diagnosed PD patients who completed questionnaires assessing their demographic characteristics, coping styles and perceived amount of information. Diagnostic consultations were video-recorded and subsequently observationally quantitatively coded for duration of information provision per topic. Statistical analyses included equivalence testing, independent t-tests and logistic regression. Results: This study found that the amount of information provided by clinicians is not equivalent for patients (N = 28) with high scores on the monitoring scale and those with high scores on the blunting scale (CI = [-0.26 – 0.37]; CI = [-0.20 – 0.43]). In addition, two independent t-tests were conducted, which showed no significant difference in the amount of information provided for high scores on the different coping styles (p = .288; p = .552). Furthermore, the likelihood of wanting to receive more or less information cannot be predicted by respectively high scores on the monitoring and blunting coping style (p > .05). Discussion: Patients’ level of monitoring or blunting was not a significant predictor for the amount of information provided and did not predict patients’ reported amount of information provided by clinicians. These findings may be influenced by limitations of self-reported questionnaires, such as the length and the small sample size of the study.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
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
Prior expectation in painful situationsmakes thepain experiencemove more towards this expectation. However, in life we do not always receivepreciseindications of the upcoming pain,leadingtofeelings...Show morePrior expectation in painful situationsmakes thepain experiencemove more towards this expectation. However, in life we do not always receivepreciseindications of the upcoming pain,leadingtofeelings ofuncertainty. Therefore research is needed to investigate the effect of uncertainty in painful situations.In this thesis we exploredthe effect of preciseoverpredictions ofpaincompared to imprecise overpredictions of pain.We expectedthat precise overpredictionsresult in a higher pain rating than imprecise overpredictions. We also investigatedthe effect of trait anxiety and intolerance of uncertainty on theeffects of these imprecisecues, since worrying and rumination might result in catastrophizing. Allhealthy23 participants included in this within-subject weretested by showingthemimprecise and precisepain indications, which were calledcues. After this,moderatelypainfulelectrical stimuli were applied,whichthe participant was asked to rate.No significant effect wasfound on the pain experience of the participant when comparing precise and imprecise overpredictions. Also,trait anxiety and intolerance of uncertainty did notshow a significant moderation effecton the pain experience in face of uncertain overpredictions.We concluded that precise andimprecise overpredictions ofpain do not show a differenceinthe amount of pain experienced. Furthermore, trait anxiety and the level of intolerance of uncertainty do not make peoplescoring high on these scalesexperience more pain in uncertain situationscompared to people who do not score high.Show less
Pain is an unpleasant subjective experience that can be influenced by various factors. One of the important determinants of the feeling of pain is how much pain one expects to feel. Usually,...Show morePain is an unpleasant subjective experience that can be influenced by various factors. One of the important determinants of the feeling of pain is how much pain one expects to feel. Usually, expecting higher pain would result in experiencing pain as more intense than it is. A factor that might interact with pain expectancies is somatic focus - how one perceives changes in the body. Previous research suggested that somatic focus might vary on a spectrum from maladaptive (hypervigilant anxious-driven) to adaptive (mindful), and that might interact with how one would perceive overpredicted pain. This within-subject study investigated how correctly predicted, as well as mildly and strongly overpredicted painful electrical stimuli of moderate intensity were rated by a healthy sample of 30 people. Their responses on the MAIA-2, scale were used to assess the adaptiveness of somatic focus. We expected that those who had a more adaptive style of somatic focus would give more accurate pain ratings to overpredicted stimuli and will follow an overpredicting pain cue to a lesser extent. Statistical analysis showed that even though the actual intensity of the moderately painful stimuli was the same every time, participants rated all overpredicted stimuli as being more painful than correctly predicted ones. Stimuli that were strongly overpredicted were rated higher than the ones that had mild overprediction. Somatic focus did not affect how much participants followed the cue in their ratings, thus more research is needed to operationalize the concept and see if it truly can be adaptive or maladaptive.Show less
