Background: The maintenance of a healthy lifestyle significantly influences pregnancy outcomes. Certain pregnant women are more at risk of engaging in unhealthy behaviors due to factors such as having a low socioeconomic position and low social capital. eHealth interventions tailored to pregnant women affected by these vulnerability factors can provide support and motivation for healthier choices.
View Article and Find Full Text PDFBackground: Self-help eHealth interventions provide automated support to change health behaviors without any further human assistance. The main advantage of self-help eHealth interventions is that they have the potential to lower the workload of health care professionals. However, one disadvantage is that they generally have a lower uptake.
View Article and Find Full Text PDFBackground: The hormone cortisol plays important roles in human circadian and stress physiology and is an interesting target for interventions. Cortisol varies not only in response to stress but also as part of a diurnal rhythm. It shows a particularly sharp increase immediately after awakening, the cortisol awakening response (CAR).
View Article and Find Full Text PDFBMJ Open
May 2023
Objective: The present study aimed to early identify patients with persistent somatic symptoms (PSS) in primary care by exploring routine care data-based approaches.
Design/setting: A cohort study based on routine primary care data from 76 general practices in the Netherlands was executed for predictive modelling.
Participants: Inclusion of 94 440 adult patients was based on: at least 7-year general practice enrolment, having more than one symptom/disease registration and >10 consultations.
Objectives: Living donor kidney transplantation is currently the preferred treatment for patients with end-stage renal disease. The psychosocial evaluation of kidney donor candidates relies mostly on the clinical viewpoint of transplant professionals because evidence-based guidelines for psychosocial donor eligibility are currently lacking. However, the accuracy of these clinical risk judgements and the potential added value of a systematic self-reported screening procedure are as yet unknown.
View Article and Find Full Text PDFBackground: eHealth interventions are developed to support and facilitate patients with lifestyle changes and self-care tasks after being diagnosed with a cardiovascular disease (CVD). Creating long-lasting effects on lifestyle change and health outcomes with eHealth interventions is challenging and requires good understanding of patient values.
Objective: The aim of the study was to identify values of importance to patients with CVD to aid in designing a technological lifestyle platform.
Objective: Persistent somatic symptoms (PSSs) are defined as symptoms not fully explained by well-established pathophysiological mechanisms and are prevalent in up to 10% of patients in primary care. The present study aimed to explore methods to identify patients with a recognisable risk of having PSS in routine primary care data.
Design: A cross-sectional study to explore four identification methods that each cover part of the broad spectrum of PSS was performed.
Background: Electronic health records (EHRs) are increasingly used for research; however, multicomponent outcome measures such as daily functioning cannot yet be readily extracted.
Aim: To evaluate whether an electronic frailty index based on routine primary care data can be used as a measure for daily functioning in research with community-dwelling older persons (aged ≥75 years).
Design And Setting: Cohort study among participants of the Integrated Systemic Care for Older People (ISCOPE) trial (11 476 eligible; 7285 in observational cohort; 3141 in trial; over-representation of frail people).
Introduction: Patients with common skin diseases may have substantial psychosocial comorbidity and reduced quality of life. This study aims at exploring further the psychosocial burden of skin diseases by assessing stigmatisation and body image problems in a large sample of patients with skin disease across Europe.
Methods And Analysis: The study is an observational cross-sectional multicentre study across 16 European countries comparing stigmatisation and body image in patients with skin disease compared with controls.
Background: Conditioned pharmacological effects may provide relevant clinical opportunities to improve treatment for patients with a variety of conditions. The aim of this systematic review was to create an overview of studies in this field of research and to investigate whether specific characteristics of the study design make for successful conditioning.
Methods: The protocol of this review was registered in Prospero (PROSPERO 2015: CRD42015024148).
In order to combat chronic immune disorders (CIDs), it is an absolute necessity to understand the bigger picture, one that goes beyond insights at a one-disease, molecular, cellular, and static level. To unravel this bigger picture we advocate an integral, cross-disciplinary approach capable of embracing the complexity of the field. This paper discusses the current knowledge on common pathways in CIDs including general psychosocial and lifestyle factors associated with immune functioning.
View Article and Find Full Text PDFBest Pract Res Clin Rheumatol
October 2016
Inflammatory rheumatic diseases have a long-lasting effect on patients' physical and psychological functioning, for instance, due to disabling symptoms and unpredictable disease course. Consequently, many patients show adjustment problems such as depressed mood, which in turn can negatively influence their disease outcome. Specific biopsychosocial factors have shown to affect this outcome.
View Article and Find Full Text PDFSkin conditions may have a strong impact on patients' sexual life, and thus influence personal relationships. Sexual issues are difficult to discuss directly in clinical practice, and a mediated instrument may be useful to capture such information. In this study item 9 of the Dermatology Life Quality Index was used to collect information on sexual impact of several skin conditions in 13 European countries.
View Article and Find Full Text PDFExpectancies can shape pain experiences. Attention for the influence of expectancies on pain has increased particularly due to research on placebo effects, of which expectancy is believed to be the core mechanism. In the current review, we provide a brief overview of the literature on the influence of expectancies on pain.
View Article and Find Full Text PDFA relationship between the intensity of itch and psychological factors like stress, coping, anxiety, and depression has often been shown in patients with skin diseases. Moreover, the biopsychosocial model of chronic itch nicely summarizes how psychological factors can contribute to a worsening or improvement of chronic itch. Thus, it is reasonable to consider psychological interventions in the treatment of chronic itch.
View Article and Find Full Text PDFObjective: Patients with somatic conditions, such as psoriasis, frequently suffer from high burden of their disease in daily life and might benefit from internet-based cognitive behavioral therapy (ICBT) tailored to their adjustment problems. The aim of this multicenter randomized controlled trial was to examine the effects of therapist-guided, individually tailored ICBT in a clinical sample of patients with psoriasis.
Methods: A total of 131 patients with psoriasis, who were screened for a psychological risk profile, were randomized to either care as usual (CAU, n = 66) or ICBT in addition to CAU (n = 65).
Objective: Stigmatization is common in people with chronic skin conditions and may also affect their significant others (SOs). The fast and implicit processing of stigmatization-related stimuli has received little attention in these populations; however, such knowledge may offer indications for new treatment methods. This study aimed to investigate implicit processing of stigmatization-related stimuli in people with skin conditions and their SOs.
View Article and Find Full Text PDFThe role of placebo and nocebo effects-that is positive or negative treatment effects that are entirely a consequence of the patient's expectations and beliefs about a treatment outcome in terms of efficacy, safety, usability or side effects-has been shown for almost all types of diseases and physiological response systems. Evidence for the relevance of placebo and nocebo effects in dermatology is also increasing, particularly for symptoms of itch and learned (conditioned) immune function. In addition, increasing knowledge is available about the neurobiological mechanisms of action, such as the role of the dopaminergic system.
View Article and Find Full Text PDFBackground: The treatment of persistent symptoms attributed to Lyme disease remains controversial. We assessed whether longer-term antibiotic treatment of persistent symptoms attributed to Lyme disease leads to better outcomes than does shorter-term treatment.
Methods: In a randomized, double-blind, placebo-controlled trial conducted in Europe, we assigned patients with persistent symptoms attributed to Lyme disease--either related temporally to proven Lyme disease or accompanied by a positive IgG or IgM immunoblot assay for Borrelia burgdorferi--to receive a 12-week oral course of doxycycline, clarithromycin plus hydroxychloroquine, or placebo.
Background: Guided online psychological self-management interventions offer broad prospects for the treatment of people with mild to moderate mental health problems, but implementation is challenging. The aims of this study are (1) to gain insight into use of and intention to use these interventions among primary care health professionals, (2) to determine the main barriers to use such interventions among non-users.
Methods: An online survey based on the Unified Theory of Acceptance and Use of Technology (UTAUT) was disseminated among mental health counsellors (MHCs; in Dutch POHs) in GP practices and primary care psychologists (PCP) in mental health care practices.
Sensitive skin is a frequent complaint in the general population, in patients, and among subjects suffering from itch. The International Forum for the Study of Itch (IFSI) decided to initiate a special interest group (SIG) on sensitive skin. Using the Delphi method, sensitive skin was defined as "A syndrome defined by the occurrence of unpleasant sensations (stinging, burning, pain, pruritus, and tingling sensations) in response to stimuli that normally should not provoke such sensations.
View Article and Find Full Text PDFPsoriasis is a chronic inflammatory skin condition with significant physical and psychosocial comorbidity. A workshop of leading experts in dermatology and psychology with the purpose of better understanding the current role of psychological comorbidities in psoriasis was held by the International Psoriasis Council in November 2013. The role of stress reactivity with a focus on the hypothalamic-pituitary-adrenal axis was emphasized.
View Article and Find Full Text PDFA substantial proportion of patients with burn injury develop chronic itch, which can severely affect their quality of life. As found in research on chronic pain, different psychophysiological processes may also play a role in chronic itch, of which central sensitization, conditioned modulation, and attentional processes have been studied most frequently. This study aimed to explore psychophysiological processes of chronic post-burn itch by comparing 15 patients with long-term itch due to burn injury with 15 matched healthy controls.
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