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: In the Netherlands, over 1,800 people annually commit suicide. Existing suicide models overlook qualitative context and Social Determinants. Thus, this study focused on understanding...Show moreBackground: In the Netherlands, over 1,800 people annually commit suicide. Existing suicide models overlook qualitative context and Social Determinants. Thus, this study focused on understanding the Social Determinants of Suicidal Ideation to find what makes life liveable. Research Questions: Focusing on a non-clinical sample of college students, we addressed several questions: “Does Financial Stress moderate the relation between Subjective Social Status and Suicidal Ideation?”, “Are there differences between college students who get Social Support or not for the relation between their Subjective Social Status and Suicidal Ideation?”, “How do aspects of Subjective Social Status influence Suicidal Ideation?”, and “How does Social Support affect the influence of Financial Stress factors on Suicidal Ideation”. Methods: The cross-sectional collection and analysis of quantitative questionnaires started off this two- phase study, followed by cross-sectional collection and analysis of qualitative interviews for four purposefully sampled participants. The explanatory sequential mixed methods design guaranteed integration. Results: Financial Stress did not moderate but underly the relationship between Subjective Social Status and Suicidal Ideation. Lower Family Income and Financial Insecurity were found to be determinants of Suicidal Ideation. Social Support moderated the relation between Subjective Social Status and Suicidal Ideation. Family Income and Financial Insecurity were found to be main aspects of Subjective Social Status determining Suicidal Ideation. Social Support was found to protect against Suicidal Ideation. Conclusion: By identifying Financial Stress, lacking Social Support, and lower Family Income as Social Determinants of Suicidal Ideation, we provide future research opportunities to work towards effective interventions for Suicidal Ideation by focusing on what makes life liveable.Show less
Earlier evidence suggests that autistic traits may be one of the strong predictors of suicidality for university students. Additionally, these traits were associated with social difficulties....Show moreEarlier evidence suggests that autistic traits may be one of the strong predictors of suicidality for university students. Additionally, these traits were associated with social difficulties. Moreover, certain social support factors, like peers and family, seem to help autistic students in dealing with suicidality. This study investigates whether there is mediation of perceived social support between the relationship of autism symptoms and suicidality. Hence, we hypothesized severe autism symptoms to be associated lower perceived social support and therefore, higher levels of suicidality. Students of Vrije University, from 11 different countries, filled our online survey. To measure symptoms of autism, perceived social support and suicidality, we used online self-report questionnaires Autism Quotient-Short (AQ-Short), Interpersonal Support Evaluation List (ISEL) and Beck Scale for Suicide Ideation (BSSI) respectively. Since results showed that the total effect autism symptoms on suicidality was not significant, there was no mediation of social support in our model. However, in contrast to expectations, autism symptoms predicted significantly higher perceived social support. As expected, higher social support predicted significantly less suicidality. While our hypothesis was the exact opposite of our results, we discuss the importance of structured support programs provided by faculties, and the requirement of raising knowledge and awareness about autism in the university population to create a safe, supportive and inclusive university environment for autistic university students.Show less
CenteringPregnancy® (CP) is a prenatal care model that provides all aspects of prenatal care in a group setting. This retrospective cohort study investigated how the CP group facilitators’ fidelity...Show moreCenteringPregnancy® (CP) is a prenatal care model that provides all aspects of prenatal care in a group setting. This retrospective cohort study investigated how the CP group facilitators’ fidelity to the CP model, social support (as perceived by the CP participants), group cohesion (as perceived by the CP group facilitators), and the CP participants’ satisfaction with care were related. Additionally, it was assessed how the perceived social support and the observed group cohesion developed over time, and to what extent these were related to each other. 637 women (mean age 30.44) and 69 groups were included. Questionnaires were used to measure perceived social support at the 28th week and 36th week of pregnancy, and satisfaction with care (PPSQ) at the 36th week. Model fidelity and group cohesion were measured by a questionnaire filled in by the group facilitators after each session. A parallel mediation analysis, a dependent samples t-test, and a one way repeated measures ANOVA were conducted. The results showed that women that felt more supported by their peers were generally more satisfied with CP care (95% CI [.15, .22]). In contrast, group facilitators’ perceptions of the groups’ cohesiveness did not predict how satisfied the women were with CP care (95% CI [-.17, .12]). It was also found that the group facilitators’ fidelity to the CP model did not predict the participants’ satisfaction with care (95% CI [-0.01, 0.00]). Further, the results showed that the participants felt increasingly supported by their peers over the course of the program (p < .001, d = .82). Similarly, the group facilitators’ perceived the CP groups to be increasingly cohesive over time (p = .001, η 2 = .02). Finally, the participants’ and group facilitators’ perceptions of social support and group cohesion were found to be weakly related (p < .001). These findings highlight that the implementation of CP in the Netherlands shows promise in enhancing maternal social support, and consequently, satisfaction with care. This study also adds unique knowledge to the evidence base of CP by assessing the cohesiveness of the groups. Future research is called upon to examine the presented relationships by applying different instruments regarding the group facilitators’ (in)fidelity to the CP model.Show less