Qualitative instruments involving clients as co-researchers to assess and improve the quality of care relationships in long-term care: an evaluation of instruments to enhance client participation in quality research.

Objectives: Enhancing the active involvement of clients as co-researchers is seen as a promising innovation in quality research. The aim of this study was to assess the feasibility and usability of five qualitative instruments used by co-researchers for assessing the quality of care relationships in long-term care.

Design And Setting: A qualitative evaluation was performed in three care organisations each focused on one of the following three client groups: frail older adults, people with mental health problems and people with intellectual disabilities.

The experience of sudden loss of a colleague or neighbor following the MH17 plane crash in the Ukraine: a qualitative interview study.

Background: The literature on loss and traumatic grief after disasters provides findings on the impact of losing a partner, child or close friend on partners, parents and friends. However, little attention has been given to the broader everyday social environment of deceased persons. The present study constitutes a qualitative exploration of the impact on colleagues and neighbors following the MH17 airplane disaster in the Ukraine, July 2014.

The initiation of Dutch newly qualified hospital-based midwives in practice, a qualitative study.

Unlabelled: In the Netherlands, a percentage of newly qualified midwives start work in maternity care as a hospital-based midwife, although prepared particularly for working autonomously in the community.

Aim: This study aimed to explore newly qualified Dutch midwives' perceptions of their job demands and resources during their initiation to hospital-based practice.

Design: We conducted a qualitative study with semi structured interviews using the Job Demands-Resources model as theoretical framework.

Effects of the Proactive Interdisciplinary Self-Management (PRISMA) Program on Online Care Platform Usage in Patients with Type 2 Diabetes in Primary Care: A Randomized Controlled Trial.

Online care platforms can support patients with type 2 diabetes (T2DM) in managing their health. However, in the use of eHealth, a low participation rate is common. The Proactive Interdisciplinary Self-Management (PRISMA) program, aimed at improving patients' self-management skills, was expected to encourage patients to manage their disease through the use of an online platform.

Amplified prevalence and incidence of cardiovascular disease in patients with inflammatory arthritis and coexistent autoimmune disorders.

Objective: This study aims to assess the prevalence proportion and incidence rate of cardiovascular morbidity in patients with inflammatory arthritis compared with that in controls, and to determine whether the co-existence of multiple autoimmune disorders is associated with an amplified risk of cardiovascular disease.

Methods: Data from the Nivel Primary Care Database were used to assess prevalence proportion and incidence rate of cardiovascular disease in patients with inflammatory arthritis only, patients with inflammatory arthritis coexistent with another autoimmune disorder, and controls. Hazard ratios were calculated using Cox regression models.

Medically unexplained symptoms: time to and triggers for diagnosis in primary care consultations.

Background: It is currently not known when in the consultation GPs label symptoms as medically unexplained and what triggers this.

Aim: To establish the moment in primary care consultations when a GP labels symptoms as medically unexplained and to explore what triggers them to do so.

Design And Setting: This was a qualitative study.

Patients' perception of communication at the interface between primary and secondary care: a cross-sectional survey in 34 countries.

Background: Poor communication between general practitioners (GPs) and medical specialists can lead to poorer quality, and continuity, of care. Our study aims to assess patients' perceptions of communication at the interface between primary and secondary care in 34 countries. It will analyse, too, whether this communication is associated with the organisation of primary care within a country, and with the characteristics of GPs and their patients.

Which difficulties do GPs experience in consultations with patients with unexplained symptoms: a qualitative study.

Background: Many general practitioners (GPs) struggle with the communication with patients with medically unexplained symptoms (MUS). This study aims to identify GPs' difficulties in communication during MUS consultations.

Methods: We video-recorded consultations and asked GPs immediately after the consultation whether MUS were presented.

Identifying subgroups of persons with multimorbidity based on their needs for care and support.

Background: There is broad consensus that countries need to develop and implement person-centred integrated care to better meet the needs of their growing populations with multimorbidity. To develop appropriate care, it is essential to know the needs for care and support among these populations. For this purpose, we examined whether subgroups of people with multimorbidity could be distinguished based on their needs, and profiled these subgroups according to medical complexity and the availability of personal resources.

A Methodological Approach for Implementing an Integrated Multimorbidity Care Model: Results from the Pre-Implementation Stage of Joint Action CHRODIS-PLUS.

Patients with multimorbidity (defined as the co-occurrence of multiple chronic diseases) frequently experience fragmented care, which increases the risk of negative outcomes. A recently proposed Integrated Multimorbidity Care Model aims to overcome many issues related to fragmented care. In the context of Joint Action CHRODIS-PLUS, an implementation methodology was developed for the care model, which is being piloted in five sites.

Effects of the Proactive interdisciplinary self-management (PRISMA) program on self-reported and clinical outcomes in type 2 diabetes: a pragmatic randomized controlled trial.

Background: Diabetes self-management education can be helpful for patients with type 2 diabetes in managing their condition. We aimed to study the effects of the group-based PRoactive Interdisciplinary Self-MAnagement (PRISMA) training program on self-reported and clinical outcomes in patients with type 2 diabetes treated in general practice.

Methods: Persons aged 18 years or older diagnosed with type 2 diabetes and treated in primary care were included.

Defining and Operationalizing Disaster Preparedness in Hospitals: A Systematic Literature Review.

Introduction: Societies invest substantial amounts of resources on disaster preparedness of hospitals. However, the concept is not clearly defined nor operationalized in the international literature.

Aim: This review aims to systematically assess definitions and operationalizations of disaster preparedness in hospitals, and to develop an all-encompassing model, incorporating different perspectives on the subject.

To what degree do patients actively choose their healthcare provider at the point of referral by their GP? A video observation study.

Background: Many countries in Europe have implemented managed competition and patient choice during the last decade. With the introduction of managed competition, health insurers also became an important stakeholder. They purchase services on behalf of their customers and are allowed to contract healthcare providers selectively.

Active participation of patients with type 2 diabetes in consultations with their primary care practice nurses - what helps and what hinders: a qualitative study.

Background: Patients with type 2 diabetes mellitus (T2DM) receiving primary care regularly visit their practice nurses (PNs). By actively participating during medical consultations, patients can better manage their disease, improving clinical outcomes and their quality of life. However, many patients with T2DM do not actively participate during medical consultations.

An assessment of the Dutch experience with health insurers acting as healthcare advisors.

Introduction: With managed competition, selective contracting and the appointing of preferred providers are important instruments for health insurers to improve their bargaining position in the healthcare purchasing market. Insurers can offer enrollees extra services, such as advice about their healthcare, to attract them, ensure that they remain loyal, and to channel them to preferred providers. We investigate which advice services insurers in the Dutch system of managed competition offer enrollees, how they inform them about services, and if enrollees use and appreciate them.

Citizens' initiatives for care and welfare in the Netherlands: an ecological analysis.

Background: In the Netherlands as well as in other countries citizens take initiatives to provide or maintain services in the area of care and welfare. Citizens' initiatives (CI's) are organisations some of which have a formal structure while others are informally connected groups of citizens, that are established by a group of citizens with the aim to increase the health and welfare within their local community and that are not focused on making a profit. Although CI's have been around since at least the 1970's little research has been done on the phenomenon, with most of it consisting of case studies or qualitative exploratory research.

Assigning a Prominent Role to "The Patient Experience" in Assessing the Quality of Integrated Care for Populations with Multiple Chronic Conditions.

In response to growing populations of citizens with multiple chronic conditions, integrated care models are being implemented in many countries. Based on our experiences from three EU co-funded actions (ICARE4EU, SUSTAIN, JA-CHRODIS), we notice that users' experiences are not always taken into account when assessing the quality of integrated care, whereas research shows that it is in this particular domain that quality improvement is most evident. The greatest value of integrated care for people with multiple chronic conditions may not lie in its potential to improve their health or reduce their use of services, but in its potential to improve their care experience, by strengthening person-centred decision-making and delivering care and support accordingly.

Tailoring the amount of treatment information to cancer patients' and survivors' preferences: Effects on patient-reported outcomes.

Objectives: Tailoring medical information to cancer patients' needs is recommended, but there is little guidance on how to tailor, and limited research exists about its effects. Tailoring to the amount of preferred information may be easily implementable in clinic and is tested here.

Methods: A video-vignette experiment was used to systematically vary video patients' information preferences (limited/extensive) and amount of provided information (additional/no additional).

From protocolized to person-centered chronic care in general practice: study protocol of an action-based research project (COPILOT).

Aim: To develop a proactive person-centered care approach for persons with (multiple) chronic diseases in general practice, and to explore the impact on 'Quadruple aims': experiences of patients and professionals, patient outcomes and costs of resources use.

Background: The management of people with multiple chronic diseases challenges health care systems designed around single disease. Patients with multimorbidity often receive highly fragmented care that may lead to inefficient, ineffective and potentially harmful treatments and neglect of essential health needs.

The impact of health symptoms on health-related quality of life in early-stage breast cancer survivors.

Purpose: In breast cancer patients, treatment-related health symptoms can occur that may affect their health-related quality of life (HRQoL). This study aimed to determine the impact of health symptoms on HRQoL in breast cancer patients up to 5 years after diagnosis.

Methods: Females surgically treated for early-stage breast cancer diagnosed between 2012 and 2016 (n = 876) were selected from the Netherlands Cancer Registry and invited for a survey about current health symptoms ('Symptoms and Perceptions questionnaire', SaP) and HRQoL ('EORTC-QLQ-C30').

Implicit and explicit attitudes towards disease-modifying antirheumatic drugs as possible target for improving medication adherence.

Objective: This study aims to explore the contribution of implicit attitudes and associations towards conventional disease-modifying antirheumatic drugs (cDMARDs), alongside explicit measures, on medication-taking behaviour and clinical outcomes in adult patients with rheumatoid arthritis (RA).

Methods: In this observational study, implicit attitudes (positive-negative) and health-related associations (health-sickness) were measured with Single Category Implicit Association Tests, whereas explicit outcomes were measured with a bipolar evaluative adjective scale and the Beliefs about Medicines Questionnaire Specific. The primary outcome of this study was medication-taking behaviour subjectively measured by self-report (i.