A 360° Approach to Personalize Lifestyle Treatment in Primary Care for People With Type 2 Diabetes: Feasibility Study.

Background: Given the multifactorial nature of type 2 diabetes (T2D), health care for this condition would benefit from a holistic approach and multidisciplinary consultation. To address this, we developed the web-based 360-degree (360°) diagnostic tool, which assesses 4 key domains: "body" (physical health parameters), "thinking and feeling" (eg, mental health and stress), "behavior" (lifestyle factors), and "environment" (eg, work and housing conditions).

Objective: This work examines the acceptability, implementation, and potential effects of the 360° diagnostic tool and subsequent tailored treatment (360° approach) in a 6-month intervention and feasibility study conducted in standard primary health care settings in the Netherlands.

360° Diagnostic Tool to Personalize Lifestyle Advice in Primary Care for People With Type 2 Diabetes: Development and Usability Study.

Background: Various multifaceted factors need to be addressed to improve the health and quality of life of people with type 2 diabetes (T2D). Therefore, we developed a web-based decision support tool that comprises a more holistic diagnosis (including 4 domains: body, thinking and feeling, behavior, and environment) and personalized advice. This 360° diagnostic tool enables people with T2D and health care professionals at the general practice to obtain an overview of the most important T2D-related issues and, subsequently, determine the most suitable intervention for the person with T2D.

REACH Worker Exposure Assessments: Ensuring Meaningful Health Risk Communication.

Objectives: Within the chemical legislation, REACH was implemented in order to improve safe working conditions with hazardous substances. Literature and real-life experiences by those concerned have shown that there are still gaps with a need for improved risk communication. This study elaborated on how information provided by REACH is understood and acted on by down- and upstream users, and how it can be further improved.

A qualitative study into the perspectives of clients on shared decision-making as a method to support return to work.

Background: Being able to participate in work is an important determinant of health. Therefore, reintegration professionals provide support to clients to return to work (RTW). Since RTW has a significant impact on a client's life, it is preferred that clients are involved in the decision-making process of RTW.

Predictors of the Acceptance of an Electronic Coach Targeting Self-management of Patients With Type 2 Diabetes: Web-Based Survey.

Background: Type 2 diabetes (T2D) is a lifestyle-related disease whose prevalence increases with age. Diabetes self-management through mobile health (mHealth) apps enables patients with T2D to improve their health. According to the Technology Acceptance Model (TAM), technology acceptance (ie, intended use) is necessary to ensure mHealth can be implemented successfully.

The Effect of a Lifestyle Intervention on Type 2 Diabetes Pathophysiology and Remission: The Stevenshof Pilot Study.

Although lifestyle interventions can lead to diabetes remission, it is unclear to what extent type 2 diabetes (T2D) remission alters or improves the underlying pathophysiology of the disease. Here, we assess the effects of a lifestyle intervention on T2D reversal or remission and the effects on the underlying pathology. In a Dutch primary care setting, 15 adults with an average T2D duration of 13.

Shared decision making from reintegration professionals' perspectives to support return to work: a qualitative study.

Background: Work participation is an important determinant of public health; being unemployed leads to a decrease in an individual's health. In the Netherlands, people with a work disability can apply for disability benefits, in which people also receive support to return to work (RTW). A method, currently used in the medical sector, that can include both the perspective of the reintegration professional and of the individual in the process of RTW, is shared decision making (SDM).

Health outcomes and experiences of direct-to-consumer high-intensity screening using both whole-body magnetic resonance imaging and cardiological examination.

Background: Alongside a clinical and research setting, whole body magnetic resonance imaging (WB-MRI) is increasingly offered as a direct-to-consumer screening service. Data is needed on the clinical relevance of findings and associated psychological impact of such screening. Therefore, we conducted a prospective follow-up study to provide insight in the effectiveness and psychological impact of direct-to-consumer screening using both WB-MRI and cardiological examination.

A Self-management Approach for Dietary Sodium Restriction in Patients With CKD: A Randomized Controlled Trial.

Rationale & Objective: Patients with chronic kidney disease (CKD) are particularly sensitive to dietary sodium. We evaluated a self-management approach for dietary sodium restriction in patients with CKD.

Study Design: Randomized controlled trial.

From Diabetes Care to Diabetes Cure-The Integration of Systems Biology, eHealth, and Behavioral Change.

From a biological view, most of the processes involved in insulin resistance, which drives the pathobiology of type 2 diabetes, are reversible. This theoretically makes the disease reversible and curable by changing dietary habits and physical activity, particularly when adopted early in the disease process. Yet, this is not fully implemented and exploited in health care due to numerous obstacles.

Variation in intrapartum referral rates in primary midwifery care in the Netherlands: a discrete choice experiment.

Objective: in midwife-led care models of maternity care, midwives are responsible for intrapartum referrals to the obstetrician or obstetric unit, in order to give their clients access to secondary obstetric care. This study explores the influence of risk perception, policy on routine labour management, and other midwife related factors on intrapartum referral decisions of Dutch midwives.

Design: a questionnaire was used, in which a referral decision was asked in 14 early labour scenarios (Discrete Choice Experiment or DCE).

Validity and Reliability of the eHealth Analysis and Steering Instrument.

Background: eHealth services can contribute to individuals' self-management, that is, performing lifestyle-related activities and decision making, to maintain a good health, or to mitigate the effect of an (chronic) illness on their health. But how effective are these services? Conducting a randomized controlled trial (RCT) is the golden standard to answer such a question, but takes extensive time and effort. The eHealth Analysis and Steering Instrument (eASI) offers a quick, but not dirty alternative.

[Reasons for having oneself vaccinated against HPV: implications for the future provision of information].

Objective: To examine which factors determined the participation in HPV vaccination programme in 2009 and 2010.

Design: Retrospective cross-sectional study.

Method: Random samples of Dutch girls who had been invited for the HPV vaccination programme in 2009 and 2010, as well as their mothers, were drawn from an Internet panel.

Determinants of HPV vaccination intentions among Dutch girls and their mothers: a cross-sectional study.

Background: The Dutch government recently added universal Human Papilloma Virus (HPV) vaccination for 12-year-old girls to the existing national immunization program. The participation rate for the initial catch-up campaign for girls aged 13 to 16 years in 2009 was lower (47%) than expected (70%). To inform future HPV information campaigns, this paper examines the social and psychological determinants of the HPV vaccination intentions of girls aged 13 to 16 years and their mothers who were targeted by the Dutch catch-up campaign of 2009.

Spontaneously published illness stories on a website for young women with breast cancer: do writers and themes reflect the wider population?

This study examined writer characteristics and themes written about in a set of 167 spontaneously published stories on a Dutch website for young women with breast cancer. The stories were coded for 6 disease characteristics and 16 themes. Coding results were compared with the characteristics of young women with breast cancer in a hospital cancer register and to the frequency of problems among young breast cancer patients participating in quantitative studies.

Is the impact of hospital performance data greater in patients who have compared hospitals?

Background: Public information on average has limited impact on patients' hospital choice. However, the impact may be greater in consumers who have compared hospitals prior to their hospital choice. We therefore assessed whether patients who have compared hospitals based their hospital choice mainly on public information, rather than e.

E-health applications and services for patient empowerment: directions for best practices in The Netherlands.

Objective: E-health may enable the empowerment process for patients, particularly the chronically ill. However, e-health is not always designed with the requirements of patient empowerment in mind. Drawing on evidence-based e-health studies, we propose directions for best practices to develop e-health that promotes patient empowerment.

How breast cancer patients want to search for and retrieve information from stories of other patients on the internet: an online randomized controlled experiment.

Background: Other patients' stories on the Internet can give patients information, support, reassurance, and practical advice.

Objectives: We examined which search facility for online stories resulted in patients' satisfaction and search success.

Methods: This study was a randomized controlled experiment with a 2x2 factorial design conducted online.

Choosing a hospital for surgery: the importance of information on quality of care.

Objective: To assess whether patients use information on quality of care when choosing a hospital for surgery compared with more general hospital information.

Methods: In this cross-sectional study in 3 Dutch hospitals, questionnaires were sent to 2122 patients who underwent 1 of 6 elective surgical procedures in 2005-2006 (aorta reconstruction [for treatment of aneurysm], cholecystectomy, colon resection, inguinal hernia repair, esophageal resection, thyroid surgery). Patients were asked which information they had used to choose this hospital and which information they intended to use if they would need similar surgical treatment in the future.

First the facts, then the values? Implicit normativity in evidence-based decision aids for shared decision-making.

This paper focuses on the ethics of constructing and using a specific evidence-based decision aid that aims to contribute to clinical shared decision-making processes. Results of this integrated empirical ethics study demonstrate how both the production and presentation of scientific information in an evidence-based decision-support contain implicit presuppositions and values, which pre-structure the moral environment of the shared decision-making process. As a consequence, the evidence-based decision support did not only support the decision-making process; it also transformed it in a morally significant way.

Putting it all behind: long-term psychological impact of an inconclusive DNA test result for breast cancer.

Purpose: An inconclusive DNA-result for breast cancer may leave women with uncertainty that cannot be relieved. We assessed the influence of beliefs women held about their inconclusive DNA-result on psychological well-being and whether women had been able to put the period of DNA testing behind them.

Methods: In total, 215 women completed a baseline and a follow-up questionnaire 2.

The impact of individualized evidence-based decision support on aneurysm patients' decision making, ideals of autonomy, and quality of life.

Background: Patients with an asymptomatic abdominal aneurysm and their surgeon were randomized to receive a general brochure (GB) or an IB presenting survival information and a ranking of the treatment strategies. Before and after receiving the brochure, patients filled out questionnaires on their behavior during the consultation, ideals of patient autonomy, and quality of life. Surgeons answered a short checklist evaluating the consultation.

Decision making regarding prophylactic mastectomy: stability of preferences and the impact of anticipated feelings of regret.

Purpose: Women who test positive for a BRCA1/2 mutation face difficult choices to manage their breast cancer risk; one of these choices is whether to opt for prophylactic mastectomy. Few data are available about this decision-making process. The current study provides data regarding the stability of risk-management preferences over time and the factors that are associated with these preferences.

Purpose in life in patients with rheumatoid arthritis.

To evaluate the role of purpose in life among people with rheumatoid arthritis (RA), a questionnaire comprising the Purpose in Life test (PIL) and the purpose in life dimension of the Psychological Well-Being test (PWB-pil) was sent to a random sample of 300 patients with RA. Additional questions comprised sociodemographic and disease characteristics, physical, mental and social functioning, coping (Coping with rheumatic stressors questionnaire), and quality of life (RAND-36). Associations between sociodemographic and disease characteristics, physical, mental and social functioning, and coping on the one side and the two measures of purpose in life on the other side and associations between the two purpose of life measures and physical and mental dimensions of quality of life were assessed by means of univariate and multivariate regression analyses.

The counsellees' view of an unclassified variant in BRCA1/2: recall, interpretation, and impact on life.

Objective: Unclassified variants (UVs, variants of uncertain clinical significance) are found in 13% of all BRCA1/2 mutation analyses. Little is known about the counsellees' recall and interpretation of a UV, and its psychosocial/medical impact.

Method: Retrospective semi-structured interviews with open questions and five-point Likert scales were carried out in 24 counsellees who received a UV result 3 years before (sd=1.