Individual patient education for low back pain.

Background: While many different types of patient education are widely used, the effect of individual patient education for low-back pain (LBP) has not yet been systematically reviewed.

Objectives: To determine whether individual patient education is effective in the treatment of non-specific low-back pain and which type is most effective.

Search Strategy: A computerized literature search of MEDLINE (1966 to July 2006), EMBASE (1988 to July 2006), CINAHL (1982 to July 2006), PsycINFO (1984 to July 2006), and the Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, Issue 2) was performed.

Family practice nurses supporting self-management in older patients with mild osteoarthritis: a randomized trial.

Background: Supporting self-management intends to improve life-style, which is beneficial for patients with mild osteoarthritis (OA). We evaluated a nurse-based intervention on older OA patients' self-management with the aim to assess its effects on mobility and functioning.

Methods: Randomized controlled trial of patients (> or = 65 years) with mild hip or knee OA from nine family practices in the Netherlands.

On the trail of quality and safety in health care.

Initiatives to improve patient care have had only limited success. , , and call for steps to encourage a new generation of researchers to investigate how to speed up progress

Obstacles to the delivery of primary palliative care as perceived by GPs.

Introduction: In order to facilitate GPs in their work and increase the possibilities for patients to remain at home, it is important to identify the obstacles which hinder the delivery of primary palliative care. From previous research we learned about some of the problems experienced by GPs. In this survey we aimed to identify the prevalence of such problems in providing palliative care and its determinants.

Effects of a nationwide programme: interventions to reduce perceived barriers to collaboration and to increase structural one-on-one contact.

Objective: To describe the implementation of a nationwide programme and to determine the effects of specific quality improvement (QI) interventions within this programme on perceived barriers to collaboration between general practitioner (GPs) and mental health professionals and frequency of structural one-on-one contact regarding individual patients.

Methods: The implementation of regional QI-interventions, perceived barriers to collaboration, and frequency of structural one-on-one contact, were assessed in a cohort study involving two surveys (2001 and 2003) among a random sample of 2757 GPs.

Results: 1336 and 1358 GPs returned baseline and follow-up questionnaires respectively.

Cue-responding behaviours of oncology nurses in video-simulated interviews.

Aim: This paper is a report of a study to describe nurse-patient interactions, i.e. nurses' cue-responding behaviour in encounters with actors playing the role of patients.

Implementing diabetes passports to focus practice reorganization on improving diabetes care.

Objective: Although an active role of the patient is often stressed in diabetes care, it is not easily implemented in daily practice. The aim of the study was to measure the effects of introducing a diabetes passport to patients after embedding the passport in the organization of care.

Design: Randomized controlled trial.

The impact of co-morbidity on GPs' pharmacological treatment decisions for patients with an anxiety disorder.

Background: Co-morbidity may influence GPs' treatment decisions for patients with anxiety. However, knowledge about differences in the pharmacological treatment of anxiety disorders in patients with and without co-morbidity is lacking.

Objective: To compare GPs' pharmacological treatment patterns for anxiety in patients with and without co-morbidity.

Treatment of myofascial trigger points in common shoulder disorders by physical therapy: a randomized controlled trial [ISRCTN75722066].

Background: Shoulder disorders are a common health problem in western societies. Several treatment protocols have been developed for the clinical management of persons with shoulder pain. However available evidence does not support any protocol as being superior over others.

Doctor performance assessment in daily practise: does it help doctors or not? A systematic review.

Context: Continuous assessment of individual performance of doctors is crucial for life-long learning and quality of care. Policy-makers and health educators should have good insights into the strengths and weaknesses of the methods available. The aim of this study was to systematically evaluate the feasibility of methods, the psychometric properties of instruments that are especially important for summative assessments, and the effectiveness of methods serving formative assessments used in routine practise to assess the performance of individual doctors.

Physical activity and adherence to compression therapy in patients with venous leg ulcers.

Objective: To assess levels of physical activity, particularly walking and leg exercises, among patients with venous leg ulcers and the extent to which patients adhere to compression therapy.

Design: Descriptive cross-sectional study.

Setting: Patients from 12 outpatient dermatology clinics were invited to participate in this study.

A practical instrument to explore patients' needs in palliative care: the Problems and Needs in Palliative Care questionnaire short version.

Objective: Short and convenient checklists are necessary tools to support and structure needs assessments in daily palliative practice. This study aims to develop a short version of the Problems and Needs in Palliative Care questionnaire (PNPC-sv); a self-report questionnaire for patients covering all dimensions of palliative care, to investigate their problems and (unmet) needs.

Methods: The original Problems and Needs in Palliative Care questionnaire (PNPC) instrument is a comprehensive checklist of problems and needs for palliative care, and has shown validity and reliability.

Primary prevention of cardiovascular diseases in general practice: mismatch between cardiovascular risk and patients' risk perceptions.

Objective: Guidelines on primary prevention of cardiovascular disease (CVD) emphasize identifying high-risk patients for more intensive management, but patients' misconceptions of risk hamper implementation. Insight is needed into the type of patients that general practitioners (GPs) encounter in their cardiovascular prevention activities. How appropriate are the risk perceptions and worries of patients with whom GPs discuss CVD risks? What determines inappropriate risk perception?

Method: Cross-sectional study in 34 general practices.

Feasibility of a new community-based geriatric intervention programme: an exploration of experiences of GPs, nurses, geriatricians, patients and caregivers.

Purpose: To determine the feasibility of the Dutch Geriatric Intervention Programme (DGIP) in primary care. Within the DGIP, a nurse cooperates with a General Practitioner (GP) and a clinical geriatrician to assess and manage care for community-living older patients. The aim of this study was to describe both views of care receivers and those of professionals in order to identify facilitating factors and barriers for implementation of the DGIP.

Effect of an integrated primary care model on the management of middle-aged and old patients with obstructive lung diseases.

Objective: To investigate the effect of a primary care model for COPD on process of care and patient outcome.

Design: Controlled study with delayed intervention in control group.

Setting: The GP delegates tasks to a COPD support service (CSS) and a practice nurse.

Sedentary patients with venous or mixed leg ulcers: determinants of physical activity.

Aim: This paper is a report of a study to identify the determinants of physical activity (PA) in patients with venous leg ulcers to develop recommendations for behavioural interventions aimed at enhancing physical activity.

Background: Physical activity promotes wound healing and prevents the recurrence of wounds in venous patients with leg ulcers. Many patients with leg ulcers, however, have a sedentary lifestyle.

Treatment reviews of older people on polypharmacy in primary care: cluster controlled trial comparing two approaches.

Background: Older people are prone to problems related to use of medicines. As they tend to use many different medicines, monitoring pharmacotherapy for older people in primary care is important.

Aim: To determine which procedure for treatment reviews (case conferences versus written feedback) results in more medication changes, measured at different moments in time.

Quality of integrated care for patients with nonsmall cell lung cancer: variations and determinants of care.

Background: In the current study, the authors focused on determinants influencing the quality of care and variations in the actual quality of integrated care for patients with nonsmall cell lung cancer (NSCLC) to estimate whether there is room for improvement.

Methods: The authors tested the quality of integrated care for 276 NSCLC patients with 14 quality indicators of professional (4 indicators), organizational (3 indicators), and patient-oriented quality (7 indicators). Patient characteristics and actual care data were derived from medical record data, patient-oriented care was derived from patient questionnaires, and professional and hospital characteristics were derived from questionnaires for professionals.

Do elderly patients feel more enabled if they had been actively involved in primary care consultations?

Objective: This study aimed to determine whether older patients' enablement was associated with their evaluation of the level of their involvement in primary care consultations.

Methods: Secondary analysis of data from an international cross-sectional study in seven European countries (n=625 patients). Patient enablement, preference for involvement in the consultation and evaluation of involvement in the consultation were measured with validated questionnaires.

WITHDRAWN: Interventions to implement prevention in primary care.

Background: Primary care physicians hold a strategic position in delivering preventive services. However discrepancies exist between evidence based guidelines and practice.

Objectives: To assess the effects of interventions to improve the delivery of preventive services in primary care.

Out-of-hours primary care: development of indicators for prescribing and referring.

Background: Dutch general practitioners have reorganized their out-of-hours primary health care to general practice cooperatives. Good insight into the quality of delivered medical care is important to make the accountability of health practitioners and managers transparent to society and to identify and minimize medical errors.

Objective: Development of a set of quality indicators for internal quality improvement in out-of-hours primary clinical care.

Shared decision-making in the Netherlands--current state and future perspectives.

Dutch government policy is aimed at introducing regulated competition among health care providers and among health care insurers and at empowering patients for being involved in decision-making in health care. Along with this, many Dutch organisations have been created to foster patient orientation within health care and increase patients' power for medical decision-making. The challenge is to deliver reliable and well-balanced information for patients and the public, eg.

Safety of telephone triage in general practitioner cooperatives: do triage nurses correctly estimate urgency?

Background: In recent years, there has been a growth in the use of triage nurses to decrease general practitioner (GP) workloads and increase the efficiency of telephone triage. The actual safety of decisions made by triage nurses has not yet been assessed.

Objectives: To investigate whether triage nurses accurately estimate the urgency level of health complaints when using the national telephone guidelines, and to examine the relationship between the performance of triage nurses and their education and training.

Parents' awareness of and knowledge about young children's urinary tract infections.

Objective: To provide insight into parents' awareness of and knowledge about urinary tract infections (UTIs) in young children.

Methods: Twenty interviews with parents who had a child recently diagnosed with a UTI were audiotaped, transcribed verbatim, and qualitatively analysed.

Results: Most parents knew the typical symptoms related to UTI.

Adherence to clean intermittent self-catheterization procedures: determinants explored.

Aims & Objectives: The aim of the current study was to explore factors that hinder or promote adherence to clean intermittent self-catheterization (CISC) procedures in adults.

Background: Clean intermittent self-catherization is associated with favourable patient outcomes, but adherence to the procedure is not addressed in the international literature.

Methods: Relevant factors were explored in two studies.