Outcome expectations play a role in the functioning of people with different immune-mediated conditions, like Bechterew’s disease, and could strengthen or convey similar effects of regular long...Show moreOutcome expectations play a role in the functioning of people with different immune-mediated conditions, like Bechterew’s disease, and could strengthen or convey similar effects of regular long-term therapy. The Wim Hof Method has shown promising results with regards to its effect on clinical, autonomic and immune response to experimentally induced inflammation. The current study aims to investigate the relationship between generic (optimism/neuroticism) and specific outcome expectations (related to training effects on health) with the functioning of patients with Bechterew’s disease. In this proof-of-concept randomized controlled trial with a cross-sectional design, 24 patients were included, who followed an adapted version of the Wim Hof Method. During this intervention, a number of areas of functioning variables were included: quality of life, anxiety, depression, and disease activity. These were measured at baseline, week 4, week 8, and a follow-up meeting at week 24. When assessing the relationship between generic and specific treatment outcome expectations, it was found that, higher levels of neuroticism are related more positive specific outcome expectations (r = .414, p = .044). It was seen that better functioning in one area was associated with better functioning in some other areas (r = .434, p < .001, r = .836, p < .001). Regarding the influence of each treatment outcome expectation separately on the different areas of functioning, neuroticism was associated with higher disease activity before and after treatment, as well as more anxiety before treatment (r = .470, p = .018, r = .567, p = .05, r = .253, p = .05). Optimism and specific treatment outcome expectations were not significantly related to functioning. Also, when the influence of baseline functioning was assessed, only the levels of depression before treatment were predictive for depression after treatment (beta = .714, p = .027). When treatment outcome expectations were taken together, they were not significant predictors for functioning after treatment. This study provides limited indications for the importance of treatment outcome expectations for alternative treatment methods. However, neuroticism plays a role in worse functioning and could be used to predict treatment response, and its influence could be addressed through neuroticism management.Show less
An effective way to reduce negative experiences such as stress, anxiety, and pain in hospitalized children is by implementing placebo applications. A placebo application is a procedure without...Show moreAn effective way to reduce negative experiences such as stress, anxiety, and pain in hospitalized children is by implementing placebo applications. A placebo application is a procedure without active elements that can elicit a positive treatment outcome. Despite its beneficial outcomes placebo applications are not frequently used in pediatric healthcare. Gaining insights in the opinions of healthcare providers on placebo applications will help to understand why placebo applications are not used frequently and offer suggestions to optimize usage. The aim of this cross-sectional observational study was to investigate whether the healthcare provider characteristics optimism, anxiety, and knowledge on placebos were associated with their opinions on the effectiveness, acceptability, and utilization of placebo applications. A differentiation is made between treatment-enhancing (e.g. music, Virtual Reality, comfort talk) and treatment-replacing (e.g. open treatment without active elements) placebo applications. Through an online questionnaire, data was collected from 121 healthcare providers (106 female, 15 male). Being more optimistic was negatively correlated with being less anxious (r = -0.43, p < 0.001). Multiple regression analyses showed that having more knowledge was associated with finding placebos applications more effective (β = 0.23, p = 0.012) and acceptable (β = 0.29, p = 0.001), but not with a higher utilization of placebo applications (p = 0.096). No significant associations were found of the amount of optimism and anxiety of healthcare providers with the opinions and use of placebo applications. Treatment-enhancing placebos applications were considered significantly more effective, acceptable, and utilized more often than treatment-replacing placebos (p-values < 0.001). The results of this study imply that more knowledge of placebos is associated with more positive opinions on placebo applications. The positive opinions and higher use of treatment-enhancing placebo applications indicate that implementing these in pediatric care is within reach. In this study, the reluctance to use placebos in pediatric care can be explained by the common assumption that placebo applications always replace the treatment, not knowing about the treatment-enhancing placebos that can be useful and ethically sound. It is recommended to offer education on treatment-enhancing and open treatment-replacing applications to examine if this increases use in pediatric care.Show less
Alopecia Areata (AA) is an autoimmune disease affecting the hair follicles resulting in irregular hair loss. The severity and unpredictability of the condition could lead to feelings of...Show moreAlopecia Areata (AA) is an autoimmune disease affecting the hair follicles resulting in irregular hair loss. The severity and unpredictability of the condition could lead to feelings of helplessness and lack of control, resulting in a decreasing quality of life. Until now no disease-specific psychological interventions exist for patients with AA. Therefore this study looked into potential contributing factors that could be implemented to improve the disease-specific quality of life of patients with AA. A questionnaire on demographic and disease-related factors was sent to Dutch Alopecia Association members. A total of 271 participants were placed in one of four subgroups based on their combination of high vs low objective and subjective AA severity; all subgroups contained ≥ 37 participants. Results showed that diseasespecific quality of life was highest in patients with a mild subjective AA condition, regardless the objective severity of the condition. Potential contributing factors related to a lower disease-specific quality of life for patients with AA were more stigmatization, fear of negative evaluation, and helplessness, and less acceptance; no major differences in contributing factors between the subgroups were found. This study signifies the importance of subjective over objective disease severity related to disease-specific quality of life in patients with AA. More research is needed on the causal relationship between disease-specific quality of life and these factors. Nevertheless, the results of this study suggest that subjective severity of AA, stigmatization, helplessness, fear of negative evaluation, and acceptance could be considered as potential contributing factors to disease-specific quality of life.Show less
